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NPI Code Detail

MEDICARE: DR. HILARY RAE DALTON D.M.D., M.S.

MEDICARE: DR. HILARY RAE DALTON D.M.D., M.S.
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
11223P0300XPeriodontics19575TX
21223P0300XPeriodonticsDN 14976FL

General Provider Information

NPI Number : 1386684421
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. HILARY RAE DALTON D.M.D., M.S.
Provider Business Mailing Address
First Line : 4148 SALTWATER BLVD
Second Line :
City : TAMPA
State : FL
Zip : 33615-5633
Country : US
Telephone Number : 813-500-5642
Fax Number : 813-254-2112
Provider Business Practice Location Address
First Line : 6025 MEMORIAL HWY
Second Line :
City : TAMPA
State : FL
Zip : 33615-4531
Country : US
Telephone Number : 813-886-2527
Fax Number : 813-887-3225
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/07/2006
Last Update Date : 07/08/2007

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