Provider Demographics
NPI:1801527122
Name:GORE, HILLARY ELIZABETH (DDS)
Entity type:Individual
Prefix:DR
First Name:HILLARY
Middle Name:ELIZABETH
Last Name:GORE
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:MISS
Other - First Name:HILLARY
Other - Middle Name:ELIZABETH
Other - Last Name:ERVIN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:N/A
Mailing Address - Street 1:7945 HUNTERS XING
Mailing Address - Street 2:
Mailing Address - City:CORDOVA
Mailing Address - State:TN
Mailing Address - Zip Code:38018-7847
Mailing Address - Country:US
Mailing Address - Phone:901-490-7205
Mailing Address - Fax:
Practice Address - Street 1:2953 BROAD AVE
Practice Address - Street 2:
Practice Address - City:MEMPHIS
Practice Address - State:TN
Practice Address - Zip Code:38112-2957
Practice Address - Country:US
Practice Address - Phone:901-842-3171
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-06-17
Last Update Date:2024-02-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN11960122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Multi-Specialty