Provider Demographics
NPI:1629654942
Name:CARA CLARK HILL DMD LLC
Entity Type:Organization
Organization Name:CARA CLARK HILL DMD LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:CARA
Authorized Official - Middle Name:
Authorized Official - Last Name:HILL
Authorized Official - Suffix:
Authorized Official - Credentials:DMD
Authorized Official - Phone:352-331-9992
Mailing Address - Street 1:1204 NW 69TH TER STE E
Mailing Address - Street 2:
Mailing Address - City:GAINESVILLE
Mailing Address - State:FL
Mailing Address - Zip Code:32605-3139
Mailing Address - Country:US
Mailing Address - Phone:352-331-9992
Mailing Address - Fax:352-331-9676
Practice Address - Street 1:1204 NW 69TH TER STE E
Practice Address - Street 2:
Practice Address - City:GAINESVILLE
Practice Address - State:FL
Practice Address - Zip Code:32605-3139
Practice Address - Country:US
Practice Address - Phone:352-331-9992
Practice Address - Fax:352-331-9676
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-03-18
Last Update Date:2021-03-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Single Specialty
No332BC3200XSuppliersDurable Medical Equipment & Medical SuppliesCustomized EquipmentGroup - Single Specialty