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General NPI Number Information
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NPI Number | 1730368739
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Entity Type | Individual
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Provider Name | KIMBERLY JACKSON HILDEBRAND D.D.S.
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Gender | Female
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Dates
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Enumeration Date | 10/26/2007
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Last Update Date | 01/04/2011
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Provider Practice Location Address
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Address Line | 5321 EAST MOCKINGBIRD LANE STE. 210
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City | DALLAS
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State | TX
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Zip | 75206
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Country | US
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Telephone | 214-824-7873
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Fax | 214-824-7873
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Provider Business Mailing Address
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Address Line | 5321 EAST MOCKINGBIRD LANE STE. NO 210
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City | DALLAS
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State | TX
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Zip | 75206
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Country | US
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Telephone | 214-824-7873
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Fax | 214-824-7873
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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 | 122300000X
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Taxonomy Name | Dentist
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License Number | 22712
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License Number State | TX
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