Provider Demographics
NPI:1730477167
Name:HILL, MARY KAY (DDS)
Entity Type:Individual
Prefix:
First Name:MARY
Middle Name:KAY
Last Name:HILL
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:MARY
Other - Middle Name:KAY
Other - Last Name:CANIGLIA
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:322 DENTAL SCIENCE S
Mailing Address - Street 2:COLLEGE OF DENTISTRY
Mailing Address - City:IOWA CITY
Mailing Address - State:IA
Mailing Address - Zip Code:52242-1001
Mailing Address - Country:US
Mailing Address - Phone:319-335-7440
Mailing Address - Fax:319-335-7451
Practice Address - Street 1:322 DENTAL SCIENCE S
Practice Address - Street 2:COLLEGE OF DENTISTRY
Practice Address - City:IOWA CITY
Practice Address - State:IA
Practice Address - Zip Code:52242-1001
Practice Address - Country:US
Practice Address - Phone:319-335-7440
Practice Address - Fax:319-335-7451
Is Sole Proprietor?:Yes
Enumeration Date:2011-07-19
Last Update Date:2012-09-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ORD96021223G0001X
IA089631223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice