Provider Demographics
NPI:1790169167
Name:HILLARY S. WADE DDS, CHARTERED
Entity Type:Organization
Organization Name:HILLARY S. WADE DDS, CHARTERED
Other - Org Name:WADE FAMILY DENTISTRY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:DENTIST/OWNER
Authorized Official - Prefix:
Authorized Official - First Name:HILLARY
Authorized Official - Middle Name:SMITH
Authorized Official - Last Name:WADE
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:301-739-4114
Mailing Address - Street 1:1855 HOWELL RD
Mailing Address - Street 2:
Mailing Address - City:HAGERSTOWN
Mailing Address - State:MD
Mailing Address - Zip Code:21740-6640
Mailing Address - Country:US
Mailing Address - Phone:301-739-4114
Mailing Address - Fax:301-739-6294
Practice Address - Street 1:1855 HOWELL RD
Practice Address - Street 2:
Practice Address - City:HAGERSTOWN
Practice Address - State:MD
Practice Address - Zip Code:21740-6640
Practice Address - Country:US
Practice Address - Phone:301-739-4114
Practice Address - Fax:301-739-6294
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-07-16
Last Update Date:2015-07-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD14475122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Single Specialty