Healthcare Provider Details

I. General information

NPI: 1174526610
Provider Name (Legal Business Name): HILDA PATRICIA PARAJON DDS
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/28/2005
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6222 US HIGHWAY 301 N
ELLENTON FL
34222-3065
US

IV. Provider business mailing address

4802 51ST ST W APT 1724
BRADENTON FL
34210-5115
US

V. Phone/Fax

Practice location:
  • Phone: 941-729-6636
  • Fax:
Mailing address:
  • Phone: 941-266-4446
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223G0001X
TaxonomyGeneral Practice Dentistry
License NumberDN 16413
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: