Provider Demographics
NPI:1801425228
Name:MCFADDEN, HILARY BLAIR (DMD)
Entity type:Individual
Prefix:
First Name:HILARY
Middle Name:BLAIR
Last Name:MCFADDEN
Suffix:
Gender:F
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:665 WASHINGTON ST UNIT 404
Mailing Address - Street 2:
Mailing Address - City:BOSTON
Mailing Address - State:MA
Mailing Address - Zip Code:02111-1638
Mailing Address - Country:US
Mailing Address - Phone:617-416-6063
Mailing Address - Fax:
Practice Address - Street 1:698 CRESCENT ST
Practice Address - Street 2:
Practice Address - City:BROCKTON
Practice Address - State:MA
Practice Address - Zip Code:02302-3360
Practice Address - Country:US
Practice Address - Phone:855-979-7145
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-04-07
Last Update Date:2020-05-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MADN1858640122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist