Provider Demographics
NPI:1518189190
Name:HILLTOP DENTAL ASSOCIATES, P.C.
Entity type:Organization
Organization Name:HILLTOP DENTAL ASSOCIATES, P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:GARY
Authorized Official - Middle Name:A
Authorized Official - Last Name:MINCHAU
Authorized Official - Suffix:
Authorized Official - Credentials:DMD
Authorized Official - Phone:814-255-6831
Mailing Address - Street 1:1736 LYTER DRIVE
Mailing Address - Street 2:WESTMONT SHOPPING CENTER
Mailing Address - City:JOHNSTOWN
Mailing Address - State:PA
Mailing Address - Zip Code:15909
Mailing Address - Country:US
Mailing Address - Phone:814-255-6831
Mailing Address - Fax:814-254-1521
Practice Address - Street 1:1736 LYTER DRIVE
Practice Address - Street 2:WESTMONT SHOPPING CENTER
Practice Address - City:JOHNSTOWN
Practice Address - State:PA
Practice Address - Zip Code:15909
Practice Address - Country:US
Practice Address - Phone:814-255-6831
Practice Address - Fax:814-254-1521
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-03
Last Update Date:2009-09-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PADS017849L1223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty