Provider Demographics
NPI:1922552132
Name:HILTON DENTAL, INC.
Entity Type:Organization
Organization Name:HILTON DENTAL, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:DAVID
Authorized Official - Middle Name:W
Authorized Official - Last Name:HILTON
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:318-542-1155
Mailing Address - Street 1:3750 PARLIAMENT DR
Mailing Address - Street 2:
Mailing Address - City:ALEXANDRIA
Mailing Address - State:LA
Mailing Address - Zip Code:71303-3011
Mailing Address - Country:US
Mailing Address - Phone:318-443-4466
Mailing Address - Fax:318-443-4811
Practice Address - Street 1:3750 PARLIAMENT DR
Practice Address - Street 2:
Practice Address - City:ALEXANDRIA
Practice Address - State:LA
Practice Address - Zip Code:71303-3011
Practice Address - Country:US
Practice Address - Phone:318-443-4466
Practice Address - Fax:318-443-4811
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-08-05
Last Update Date:2016-08-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
LA1843580Medicaid