Provider Demographics
NPI:1568478592
Name:HILDEBRANDT, DONALD GORDON (DDS)
Entity Type:Individual
Prefix:DR
First Name:DONALD
Middle Name:GORDON
Last Name:HILDEBRANDT
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6003 W THUNDERBIRD RD
Mailing Address - Street 2:SUITE 2
Mailing Address - City:GLENDALE
Mailing Address - State:AZ
Mailing Address - Zip Code:85306-4004
Mailing Address - Country:US
Mailing Address - Phone:602-843-3556
Mailing Address - Fax:602-843-9664
Practice Address - Street 1:6003 W THUNDERBIRD RD
Practice Address - Street 2:SUITE 2
Practice Address - City:GLENDALE
Practice Address - State:AZ
Practice Address - Zip Code:85306-4004
Practice Address - Country:US
Practice Address - Phone:602-843-3556
Practice Address - Fax:602-843-9664
Is Sole Proprietor?:No
Enumeration Date:2006-07-31
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ45001223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice