Provider Demographics
NPI:1710538228
Name:HILL, ERIC THOMAS (RDH)
Entity Type:Individual
Prefix:MR
First Name:ERIC
Middle Name:THOMAS
Last Name:HILL
Suffix:
Gender:M
Credentials:RDH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:203 BUSINESS CENTER LOOP
Mailing Address - Street 2:
Mailing Address - City:KALISPELL
Mailing Address - State:MT
Mailing Address - Zip Code:59901-6885
Mailing Address - Country:US
Mailing Address - Phone:406-752-4545
Mailing Address - Fax:
Practice Address - Street 1:203 BUSINESS CENTER LOOP
Practice Address - Street 2:
Practice Address - City:KALISPELL
Practice Address - State:MT
Practice Address - Zip Code:59901-6885
Practice Address - Country:US
Practice Address - Phone:406-752-4545
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-09-25
Last Update Date:2019-09-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MTDEN-RDH-LIC-15272124Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes124Q00000XDental ProvidersDental Hygienist