Provider Demographics
NPI:1730290917
Name:HILL, BRIEN KEVIN (DDS)
Entity Type:Individual
Prefix:DR
First Name:BRIEN
Middle Name:KEVIN
Last Name:HILL
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7888 LA MESA BLVD
Mailing Address - Street 2:
Mailing Address - City:LA MESA
Mailing Address - State:CA
Mailing Address - Zip Code:91941-3633
Mailing Address - Country:US
Mailing Address - Phone:619-460-8211
Mailing Address - Fax:619-461-8960
Practice Address - Street 1:7888 LA MESA BLVD
Practice Address - Street 2:
Practice Address - City:LA MESA
Practice Address - State:CA
Practice Address - Zip Code:91941-3633
Practice Address - Country:US
Practice Address - Phone:619-460-8211
Practice Address - Fax:619-461-8960
Is Sole Proprietor?:No
Enumeration Date:2006-08-31
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA036247122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist