Provider Demographics
NPI:1790854891
Name:HILDEBRANDT, GARY (DDS,MS)
Entity Type:Individual
Prefix:DR
First Name:GARY
Middle Name:
Last Name:HILDEBRANDT
Suffix:
Gender:M
Credentials:DDS,MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:920 FELTL CT
Mailing Address - Street 2:APT. #251
Mailing Address - City:HOPKINS
Mailing Address - State:MN
Mailing Address - Zip Code:55343-6100
Mailing Address - Country:US
Mailing Address - Phone:612-625-5130
Mailing Address - Fax:612-625-7440
Practice Address - Street 1:7501 GOLDEN VALLEY RD
Practice Address - Street 2:
Practice Address - City:GOLDEN VALLEY
Practice Address - State:MN
Practice Address - Zip Code:55427-4563
Practice Address - Country:US
Practice Address - Phone:763-544-2213
Practice Address - Fax:763-541-1758
Is Sole Proprietor?:No
Enumeration Date:2006-11-06
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN110831223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice