Provider Demographics
NPI:1861494973
Name:HILLIN, JOHN BRUCE (DDS)
Entity Type:Individual
Prefix:
First Name:JOHN
Middle Name:BRUCE
Last Name:HILLIN
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 1:109 RICHARDSON DR
Mailing Address - Street 2:
Mailing Address - City:HENDERSON
Mailing Address - State:TX
Mailing Address - Zip Code:75654-3989
Mailing Address - Country:US
Mailing Address - Phone:903-657-2266
Mailing Address - Fax:903-657-1090
Practice Address - Street 1:109 RICHARDSON DR
Practice Address - Street 2:
Practice Address - City:HENDERSON
Practice Address - State:TX
Practice Address - Zip Code:75654-3989
Practice Address - Country:US
Practice Address - Phone:903-657-2266
Practice Address - Fax:903-657-1090
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-06-01
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX124531223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice