Provider Demographics
NPI:1558478594
Name:RICHARD D HYLTOIR DDS PC
Entity Type:Organization
Organization Name:RICHARD D HYLTOIR DDS PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:RICHARD
Authorized Official - Middle Name:DAY
Authorized Official - Last Name:HYLTON
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:804-633-5487
Mailing Address - Street 1:PO BOX 464
Mailing Address - Street 2:
Mailing Address - City:BOWLING GREEN
Mailing Address - State:VA
Mailing Address - Zip Code:22427-0464
Mailing Address - Country:US
Mailing Address - Phone:804-633-5487
Mailing Address - Fax:804-632-9641
Practice Address - Street 1:135 S MAIN ST
Practice Address - Street 2:
Practice Address - City:BOWLING GREEN
Practice Address - State:VA
Practice Address - Zip Code:22427-0464
Practice Address - Country:US
Practice Address - Phone:804-633-5487
Practice Address - Fax:804-632-9641
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-24
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA04010034981223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty