Provider Demographics
NPI:1558384339
Name:HILGERS, KELLY KATHLEEN (DDS)
Entity Type:Individual
Prefix:DR
First Name:KELLY
Middle Name:KATHLEEN
Last Name:HILGERS
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 1:14425 W. MCDOWELL RD.
Mailing Address - Street 2:SUITE F102
Mailing Address - City:GOODYEAR
Mailing Address - State:AZ
Mailing Address - Zip Code:85395
Mailing Address - Country:US
Mailing Address - Phone:623-536-0079
Mailing Address - Fax:623-535-5176
Practice Address - Street 1:14425 W. MCDOWELL RD.
Practice Address - Street 2:SUITE F102
Practice Address - City:GOODYEAR
Practice Address - State:AZ
Practice Address - Zip Code:85395
Practice Address - Country:US
Practice Address - Phone:623-536-0079
Practice Address - Fax:623-535-5176
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-25
Last Update Date:2015-07-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ66931223P0221X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223P0221XDental ProvidersDentistPediatric Dentistry