Provider Demographics
NPI:1386037885
Name:HILARRY A. DOUGLAS DDS
Entity Type:Organization
Organization Name:HILARRY A. DOUGLAS DDS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DENTIST
Authorized Official - Prefix:DR
Authorized Official - First Name:HILARRY
Authorized Official - Middle Name:A
Authorized Official - Last Name:DOUGLAS
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:480-855-7888
Mailing Address - Street 1:575 W. CHANDLER BLVD.
Mailing Address - Street 2:STE 223
Mailing Address - City:CHANDLER
Mailing Address - State:AZ
Mailing Address - Zip Code:85225
Mailing Address - Country:US
Mailing Address - Phone:480-855-7888
Mailing Address - Fax:480-855-5502
Practice Address - Street 1:575 W CHANDLER BLVD
Practice Address - Street 2:STE 223
Practice Address - City:CHANDLER
Practice Address - State:AZ
Practice Address - Zip Code:85225-7541
Practice Address - Country:US
Practice Address - Phone:480-855-7888
Practice Address - Fax:480-855-5502
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-03-09
Last Update Date:2015-03-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZD53651223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty