Provider Demographics
NPI:1578788311
Name:PECK, HILLARY K (DDS)
Entity Type:Individual
Prefix:
First Name:HILLARY
Middle Name:K
Last Name:PECK
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 1:14640 N TATUM BLVD STE 10
Mailing Address - Street 2:
Mailing Address - City:PHOENIX
Mailing Address - State:AZ
Mailing Address - Zip Code:85032-4824
Mailing Address - Country:US
Mailing Address - Phone:602-867-1398
Mailing Address - Fax:602-867-1702
Practice Address - Street 1:14640 N TATUM BLVD STE 10
Practice Address - Street 2:
Practice Address - City:PHOENIX
Practice Address - State:AZ
Practice Address - Zip Code:85032-4824
Practice Address - Country:US
Practice Address - Phone:602-867-1398
Practice Address - Fax:602-867-1702
Is Sole Proprietor?:No
Enumeration Date:2007-04-16
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ4181122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist