Provider Demographics
NPI:1750798112
Name:HILLYER, CARRI (RDH)
Entity type:Individual
Prefix:
First Name:CARRI
Middle Name:
Last Name:HILLYER
Suffix:
Gender:F
Credentials:RDH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2998 GINNALA DR
Mailing Address - Street 2:SUITE 101
Mailing Address - City:LOVELAND
Mailing Address - State:CO
Mailing Address - Zip Code:80538-7819
Mailing Address - Country:US
Mailing Address - Phone:970-669-1236
Mailing Address - Fax:970-622-8521
Practice Address - Street 1:2998 GINNALA DR
Practice Address - Street 2:SUITE 101
Practice Address - City:LOVELAND
Practice Address - State:CO
Practice Address - Zip Code:80538-7819
Practice Address - Country:US
Practice Address - Phone:970-669-1236
Practice Address - Fax:970-622-8521
Is Sole Proprietor?:No
Enumeration Date:2014-07-17
Last Update Date:2014-07-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CODH 002023532124Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes124Q00000XDental ProvidersDental Hygienist