MEDICARE: JOSHUA MICHAEL HILLER D.D.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
1	122300000X	Dentist	D12241	MN
2	1223G0001X	General Practice Dentistry	DE60148458	WA

General Provider Information

NPI Number	:	1639252471
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JOSHUA MICHAEL HILLER D.D.S.

Provider Business Mailing Address
First Line	:	223 NW 153RD ST
Second Line	:
City	:	VANCOUVER
State	:	WA
Zip	:	98685-1796
Country	:	US
Telephone Number	:	801-648-8551
Fax Number	:

Provider Business Practice Location Address
First Line	:	14313 NE 20TH AVE
Second Line	:	SUITE A101
City	:	VANCOUVER
State	:	WA
Zip	:	98686-1487
Country	:	US
Telephone Number	:	360-574-3985
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	10/23/2006
Last Update Date	:	07/05/2014

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Directions to “ JOSHUA MICHAEL HILLER D.D.S.” Practice Location

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