Provider Demographics
NPI:1558370502
Name:PAYNE, SUSAN HILL (DDS)
Entity Type:Individual
Prefix:DR
First Name:SUSAN
Middle Name:HILL
Last Name:PAYNE
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 1:256 S LEGGETT DR
Mailing Address - Street 2:
Mailing Address - City:ABILENE
Mailing Address - State:TX
Mailing Address - Zip Code:79605-1628
Mailing Address - Country:US
Mailing Address - Phone:325-672-9191
Mailing Address - Fax:325-672-5502
Practice Address - Street 1:256 S LEGGETT DR
Practice Address - Street 2:
Practice Address - City:ABILENE
Practice Address - State:TX
Practice Address - Zip Code:79605-1628
Practice Address - Country:US
Practice Address - Phone:325-672-9191
Practice Address - Fax:325-672-5502
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-07
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX187861223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice