=====================================================
General NPI Number Information
=====================================================
NPI Number | 1134380033
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | TERENCE C HILGER DDS
-----------------------------------------------------
Gender | Male
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 06/23/2008
-----------------------------------------------------
Last Update Date | 06/23/2008
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 5722 INTEGRITY DR B S-771 NAV SUP ACT MID SOUTH
-----------------------------------------------------
City | MILLINGTON
-----------------------------------------------------
State | TN
-----------------------------------------------------
Zip | 38054-5028
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 901-874-6100
-----------------------------------------------------
Fax | 901-874-5060
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 5722 INTEGRITY DR B S-771 NAV SUP ACT MID SOUTH
-----------------------------------------------------
City | MILLINGTON
-----------------------------------------------------
State | TN
-----------------------------------------------------
Zip | 38054-5028
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 901-874-6100
-----------------------------------------------------
Fax | 901-874-5060
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 1223P0700X
-----------------------------------------------------
Taxonomy Name | Prosthodontics
-----------------------------------------------------
License Number | DS2106
-----------------------------------------------------
License Number State | TN
-----------------------------------------------------