Provider Demographics
NPI:1952641201
Name:JULIA R. HILL, DMD, PA
Entity Type:Organization
Organization Name:JULIA R. HILL, DMD, PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/PRES.
Authorized Official - Prefix:
Authorized Official - First Name:JULIA
Authorized Official - Middle Name:R
Authorized Official - Last Name:HILL
Authorized Official - Suffix:
Authorized Official - Credentials:DMD
Authorized Official - Phone:662-887-1133
Mailing Address - Street 1:104 W. GRESHAM ST.
Mailing Address - Street 2:
Mailing Address - City:INDIANOLA
Mailing Address - State:MS
Mailing Address - Zip Code:38751
Mailing Address - Country:US
Mailing Address - Phone:662-887-1133
Mailing Address - Fax:662-887-4487
Practice Address - Street 1:104 W. GRESHAM ST.
Practice Address - Street 2:
Practice Address - City:INDIANOLA
Practice Address - State:MS
Practice Address - Zip Code:38751
Practice Address - Country:US
Practice Address - Phone:662-887-1133
Practice Address - Fax:662-887-4487
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-02-25
Last Update Date:2013-02-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MS2729-93122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MS0660046Medicaid