Provider Demographics
NPI:1609225697
Name:HILL, AMY BALESTRINO (DDS)
Entity Type:Individual
Prefix:DR
First Name:AMY
Middle Name:BALESTRINO
Last Name:HILL
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 1:61 PEYTON PKWY STE 103
Mailing Address - Street 2:
Mailing Address - City:COLLIERVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:38017-9702
Mailing Address - Country:US
Mailing Address - Phone:901-861-0031
Mailing Address - Fax:
Practice Address - Street 1:61 PEYTON PKWY STE 103
Practice Address - Street 2:
Practice Address - City:COLLIERVILLE
Practice Address - State:TN
Practice Address - Zip Code:38017-9702
Practice Address - Country:US
Practice Address - Phone:901-861-0031
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-06-09
Last Update Date:2018-12-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN102741223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice