Provider Demographics
NPI:1558798280
Name:HILCREST DENTAL CLINIC INC.
Entity Type:Organization
Organization Name:HILCREST DENTAL CLINIC INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:MRS
Authorized Official - First Name:SHERRY
Authorized Official - Middle Name:DAWN
Authorized Official - Last Name:PAFFRATH
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:931-289-3122
Mailing Address - Street 1:4889 E MAIN ST
Mailing Address - Street 2:
Mailing Address - City:ERIN
Mailing Address - State:TN
Mailing Address - Zip Code:37061-4115
Mailing Address - Country:US
Mailing Address - Phone:931-289-3122
Mailing Address - Fax:931-289-5832
Practice Address - Street 1:4889 E MAIN ST
Practice Address - Street 2:
Practice Address - City:ERIN
Practice Address - State:TN
Practice Address - Zip Code:37061-4115
Practice Address - Country:US
Practice Address - Phone:931-289-3122
Practice Address - Fax:931-289-5832
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-09-26
Last Update Date:2013-09-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN468122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Single Specialty