Provider Demographics
NPI:1255015871
Name:HILL, TERESSA RAE (DDS)
Entity type:Individual
Prefix:DR
First Name:TERESSA
Middle Name:RAE
Last Name:HILL
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7225 9TH AVE APT 1712
Mailing Address - Street 2:
Mailing Address - City:PORT ARTHUR
Mailing Address - State:TX
Mailing Address - Zip Code:77642-2204
Mailing Address - Country:US
Mailing Address - Phone:330-605-7946
Mailing Address - Fax:
Practice Address - Street 1:4179 DOWLEN RD
Practice Address - Street 2:
Practice Address - City:BEAUMONT
Practice Address - State:TX
Practice Address - Zip Code:77706-6852
Practice Address - Country:US
Practice Address - Phone:409-227-1653
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-06-14
Last Update Date:2023-06-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX39704122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist