Provider Demographics
NPI:1356583884
Name:HILTON, THOMAS J (DMD, MS)
Entity type:Individual
Prefix:DR
First Name:THOMAS
Middle Name:J
Last Name:HILTON
Suffix:
Gender:M
Credentials:DMD, MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11786 SW BARNES RD
Mailing Address - Street 2:SUITE 320
Mailing Address - City:PORTLAND
Mailing Address - State:OR
Mailing Address - Zip Code:97225
Mailing Address - Country:US
Mailing Address - Phone:503-641-3550
Mailing Address - Fax:
Practice Address - Street 1:11786 SW BARNES RD
Practice Address - Street 2:SUITE 320
Practice Address - City:PORTLAND
Practice Address - State:OR
Practice Address - Zip Code:97225
Practice Address - Country:US
Practice Address - Phone:503-641-3550
Practice Address - Fax:503-574-2078
Is Sole Proprietor?:No
Enumeration Date:2009-03-30
Last Update Date:2009-04-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ORORD8515122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist