Provider Demographics
NPI:1598879660
Name:MASON DENTAL CARE; DANIEL S. HILLIS, D.M.D., LLC
Entity Type:Organization
Organization Name:MASON DENTAL CARE; DANIEL S. HILLIS, D.M.D., LLC
Other - Org Name:MASON DENTAL CARE, LLC
Other - Org Type:Doing Business As
Authorized Official - Title/Position:DENTIST/OWNER AND OPERATOR
Authorized Official - Prefix:DR
Authorized Official - First Name:DANIEL
Authorized Official - Middle Name:SCOTT
Authorized Official - Last Name:HILLIS
Authorized Official - Suffix:
Authorized Official - Credentials:DMD
Authorized Official - Phone:513-336-8510
Mailing Address - Street 1:6499 S MASON MONTGOMERY RD
Mailing Address - Street 2:SUITE B
Mailing Address - City:MASON
Mailing Address - State:OH
Mailing Address - Zip Code:45040-1764
Mailing Address - Country:US
Mailing Address - Phone:513-336-8510
Mailing Address - Fax:513-336-7359
Practice Address - Street 1:6499 S MASON MONTGOMERY RD
Practice Address - Street 2:SUITE B
Practice Address - City:MASON
Practice Address - State:OH
Practice Address - Zip Code:45040-1764
Practice Address - Country:US
Practice Address - Phone:513-336-8510
Practice Address - Fax:513-336-7359
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-18
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH214511223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty