Provider Demographics
NPI:1811146251
Name:HALL & HILL FAMILY DENTISTRY,LLC
Entity type:Organization
Organization Name:HALL & HILL FAMILY DENTISTRY,LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/PARTNERSHIP
Authorized Official - Prefix:DR
Authorized Official - First Name:WILLIE
Authorized Official - Middle Name:J
Authorized Official - Last Name:HILL
Authorized Official - Suffix:JR
Authorized Official - Credentials:DDS
Authorized Official - Phone:864-232-8393
Mailing Address - Street 1:PO BOX 8598
Mailing Address - Street 2:
Mailing Address - City:GREENVILLE
Mailing Address - State:SC
Mailing Address - Zip Code:29604-8598
Mailing Address - Country:US
Mailing Address - Phone:864-232-8393
Mailing Address - Fax:864-242-6944
Practice Address - Street 1:813 AUGUSTA ST
Practice Address - Street 2:
Practice Address - City:GREENVILLE
Practice Address - State:SC
Practice Address - Zip Code:29605-3842
Practice Address - Country:US
Practice Address - Phone:864-232-8393
Practice Address - Fax:864-242-6944
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-09-10
Last Update Date:2008-09-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC17471223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
SC1700961414Medicaid