Provider Demographics
NPI:1598812489
Name:HILL, MATTHEW DAVID (DDS)
Entity Type:Individual
Prefix:DR
First Name:MATTHEW
Middle Name:DAVID
Last Name:HILL
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 1:2910 BROADWAY BLVD STE 101
Mailing Address - Street 2:
Mailing Address - City:GARLAND
Mailing Address - State:TX
Mailing Address - Zip Code:75041-3797
Mailing Address - Country:US
Mailing Address - Phone:972-271-1574
Mailing Address - Fax:972-271-6588
Practice Address - Street 1:2910 BROADWAY BLVD STE 101
Practice Address - Street 2:
Practice Address - City:GARLAND
Practice Address - State:TX
Practice Address - Zip Code:75041-3797
Practice Address - Country:US
Practice Address - Phone:972-271-1574
Practice Address - Fax:972-271-6588
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-04
Last Update Date:2009-09-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX00245451223X0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223X0400XDental ProvidersDentistOrthodontics and Dentofacial Orthopedics