Provider Demographics
NPI:1679657951
Name:HILL, JULIA R (DMD)
Entity Type:Individual
Prefix:DR
First Name:JULIA
Middle Name:R
Last Name:HILL
Suffix:
Gender:F
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:104 W GRESHAM ST
Mailing Address - Street 2:
Mailing Address - City:INDIANOLA
Mailing Address - State:MS
Mailing Address - Zip Code:38751-2199
Mailing Address - Country:US
Mailing Address - Phone:662-887-1133
Mailing Address - Fax:662-887-4487
Practice Address - Street 1:104 W GRESHAM ST
Practice Address - Street 2:
Practice Address - City:INDIANOLA
Practice Address - State:MS
Practice Address - Zip Code:38751-2199
Practice Address - Country:US
Practice Address - Phone:662-887-1133
Practice Address - Fax:662-887-4487
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-24
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MS2729-931223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice
Provider Identifiers
StateIdentifier IDID TypeIssuer
MS00660046Medicaid