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General NPI Number Information
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NPI Number | 1821292210
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Entity Type | Organization
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Legal Business Name | O. JERRY HILL, JR. DDS, PA
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Dates
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Enumeration Date | 06/12/2007
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Last Update Date | 11/06/2007
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Provider Practice Location Address
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Address Line | 925 THOMAS ST
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City | STATESVILLE
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State | NC
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Zip | 28677-3484
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Country | US
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Telephone | 704-873-0263
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Fax | 704-873-1813
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Provider Business Mailing Address
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Address Line | 925 THOMAS ST
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City | STATESVILLE
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State | NC
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Zip | 28677-3484
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Country | US
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Telephone | 704-873-0263
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Fax | 704-873-1813
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Authorized Official
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Title or Position | OWNER
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Name | DR. OREN JERRY HILL JR.
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Credential | DDS
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Telephone | 704-873-0263
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1223S0112X
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Taxonomy Name | Oral and Maxillofacial Surgery (Dentist)
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License Number | 4205
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License Number State | NC
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