Provider Demographics
NPI:1417183658
Name:WADE, HILLARY S (DDS)
Entity Type:Individual
Prefix:MISS
First Name:HILLARY
Middle Name:S
Last Name:WADE
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1855 HOWELL RD
Mailing Address - Street 2:
Mailing Address - City:HAGERSTOWN
Mailing Address - State:MD
Mailing Address - Zip Code:21740-6640
Mailing Address - Country:US
Mailing Address - Phone:301-739-4114
Mailing Address - Fax:301-739-6294
Practice Address - Street 1:1855 HOWELL RD
Practice Address - Street 2:
Practice Address - City:HAGERSTOWN
Practice Address - State:MD
Practice Address - Zip Code:21740-6640
Practice Address - Country:US
Practice Address - Phone:301-739-4114
Practice Address - Fax:301-739-6294
Is Sole Proprietor?:Yes
Enumeration Date:2009-06-02
Last Update Date:2009-06-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD14475122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist