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General NPI Number Information
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NPI Number | 1659418200
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Entity Type | Individual
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Provider Name | TODD LYLE HILLYARD D.D.S.
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Gender | Male
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Dates
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Enumeration Date | 01/31/2007
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Last Update Date | 08/28/2008
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Provider Practice Location Address
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Address Line | 2501 NE 134TH ST SUITE 105
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City | VANCOUVER
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State | WA
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Zip | 98686-3026
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Country | US
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Telephone | 360-604-9000
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Fax | 360-573-1417
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Provider Business Mailing Address
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Address Line | 2501 NE 134TH ST SUITE 105
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City | VANCOUVER
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State | WA
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Zip | 98686-3026
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Country | US
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Telephone | 360-604-9000
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Fax | 360-573-1417
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1223P0221X
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Taxonomy Name | Pediatric Dentistry
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License Number | 49899
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License Number State | CA
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