Healthcare Provider Details

I. General information

NPI: 1053867986
Provider Name (Legal Business Name): JASON L HILDE DDS PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/31/2016
Last Update Date: 08/31/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

120 E GEORGE HOPPER RD SUITE 210
BURLINGTON WA
98233-3125
US

IV. Provider business mailing address

120 E GEORGE HOPPER RD SUITE 210
BURLINGTON WA
98233-3125
US

V. Phone/Fax

Practice location:
  • Phone: 360-707-5353
  • Fax: 360-707-5343
Mailing address:
  • Phone: 360-707-5353
  • Fax: 360-707-5343

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223G0001X
TaxonomyGeneral Practice Dentistry
License NumberDE00008441
License Number StateWA

VIII. Authorized Official

Name: DR. JASON L HILDE
Title or Position: OWNER
Credential: DDS
Phone: 360-707-5353