Provider Demographics
NPI:1336365055
Name:HILT, RAYMOND JAY (DDS)
Entity Type:Individual
Prefix:DR
First Name:RAYMOND
Middle Name:JAY
Last Name:HILT
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 1:1065 FOURTH ST
Mailing Address - Street 2:
Mailing Address - City:MUSKEGON
Mailing Address - State:MI
Mailing Address - Zip Code:49440
Mailing Address - Country:US
Mailing Address - Phone:231-722-6550
Mailing Address - Fax:231-722-3533
Practice Address - Street 1:1065 FOURTH ST
Practice Address - Street 2:
Practice Address - City:MUSKEGON
Practice Address - State:MI
Practice Address - Zip Code:49440
Practice Address - Country:US
Practice Address - Phone:231-722-6550
Practice Address - Fax:231-722-3533
Is Sole Proprietor?:No
Enumeration Date:2007-04-18
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI29010076611223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice