Provider Demographics
NPI:1386656130
Name:MARK F. HILTON, DDS, PC
Entity Type:Organization
Organization Name:MARK F. HILTON, DDS, PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:MARK
Authorized Official - Middle Name:F
Authorized Official - Last Name:HILTON
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:314-831-4660
Mailing Address - Street 1:4585 WASHINGTON ST
Mailing Address - Street 2:C-3
Mailing Address - City:FLORISSANT
Mailing Address - State:MO
Mailing Address - Zip Code:63033-5858
Mailing Address - Country:US
Mailing Address - Phone:314-831-4660
Mailing Address - Fax:
Practice Address - Street 1:4585 WASHINGTON ST
Practice Address - Street 2:C-3
Practice Address - City:FLORISSANT
Practice Address - State:MO
Practice Address - Zip Code:63033-5858
Practice Address - Country:US
Practice Address - Phone:314-831-4660
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-12
Last Update Date:2010-01-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MODE0141461223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty