Provider Demographics
NPI:1265082093
Name:HILLTOP DENTAL LLC
Entity type:Organization
Organization Name:HILLTOP DENTAL LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/OFFICER
Authorized Official - Prefix:DR
Authorized Official - First Name:MOHAMMAD
Authorized Official - Middle Name:
Authorized Official - Last Name:ELKHATIB
Authorized Official - Suffix:
Authorized Official - Credentials:DMD
Authorized Official - Phone:240-328-2309
Mailing Address - Street 1:2836 MILLERS WAY DR
Mailing Address - Street 2:
Mailing Address - City:ELLICOTT CITY
Mailing Address - State:MD
Mailing Address - Zip Code:21043-1964
Mailing Address - Country:US
Mailing Address - Phone:240-328-2309
Mailing Address - Fax:
Practice Address - Street 1:605 BALTIMORE ANNAPOLIS BLVD STE 1
Practice Address - Street 2:
Practice Address - City:SEVERNA PARK
Practice Address - State:MD
Practice Address - Zip Code:21146-3930
Practice Address - Country:US
Practice Address - Phone:240-328-2309
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-09-13
Last Update Date:2019-09-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Multi-Specialty