Healthcare Provider Details

I. General information

NPI: 1831113646
Provider Name (Legal Business Name): DAVID RUSSELL HILL DDS
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/26/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7201 N INTERSTATE AVE
PORTLAND OR
97217-5523
US

IV. Provider business mailing address

7807 NW 12TH AVE
VANCOUVER WA
98665-6031
US

V. Phone/Fax

Practice location:
  • Phone: 503-286-6860
  • Fax:
Mailing address:
  • Phone: 360-566-9191
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223P0700X
TaxonomyProsthodontics
License NumberD7721
License Number StateOR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: