Provider Demographics
NPI:1942649058
Name:HILLCREST DENTAL CARE INC
Entity Type:Organization
Organization Name:HILLCREST DENTAL CARE INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:HUMAN RESOURCE MANAGER
Authorized Official - Prefix:MS
Authorized Official - First Name:KRISTEN
Authorized Official - Middle Name:
Authorized Official - Last Name:ELCOX
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:413-445-6680
Mailing Address - Street 1:77 HOSPITAL AVE
Mailing Address - Street 2:SUITE 102
Mailing Address - City:NORTH ADAMS
Mailing Address - State:MA
Mailing Address - Zip Code:01247-2538
Mailing Address - Country:US
Mailing Address - Phone:413-346-4242
Mailing Address - Fax:413-346-4276
Practice Address - Street 1:77 HOSPITAL AVE
Practice Address - Street 2:SUITE 102
Practice Address - City:NORTH ADAMS
Practice Address - State:MA
Practice Address - Zip Code:01247-2550
Practice Address - Country:US
Practice Address - Phone:413-346-4242
Practice Address - Fax:413-346-4276
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-06-21
Last Update Date:2015-02-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes261QD0000XAmbulatory Health Care FacilitiesClinic/CenterDental
No122300000XDental ProvidersDentistGroup - Single Specialty
No1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA110032460BMedicaid