Healthcare Provider Details

I. General information

NPI: 1154381242
Provider Name (Legal Business Name): COLIN HILL ELIOT D.D.S.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/24/2006
Last Update Date: 04/22/2025
Certification Date: 04/22/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1120 E OWEN K GARRIOTT RD STE L
ENID OK
73701-6136
US

IV. Provider business mailing address

915 E OWEN K GARRIOTT RD STE L
ENID OK
73701-6155
US

V. Phone/Fax

Practice location:
  • Phone: 580-237-1933
  • Fax: 802-977-0165
Mailing address:
  • Phone: 580-237-1933
  • Fax: 405-340-5162

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code1223G0001X
TaxonomyGeneral Practice Dentistry
License Number5783
License Number StateOK
# 2
Primary TaxonomyY
Taxonomy Code1223E0200X
TaxonomyEndodontics
License Number76
License Number StateOK

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: