MEDICARE: DR. RICHARD DOUGLAS HILL D.D.S.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	1223G0001X	General Practice Dentistry	3748	OK

General Provider Information

NPI Number	:	1275535957
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. RICHARD DOUGLAS HILL D.D.S.

Provider Business Mailing Address
First Line	:	9119 S TOLEDO AVE
Second Line	:
City	:	TULSA
State	:	OK
Zip	:	74137-2719
Country	:	US
Telephone Number	:	918-749-6841
Fax Number	:	918-749-6859

Provider Business Practice Location Address
First Line	:	9119 S TOLEDO AVE
Second Line	:
City	:	TULSA
State	:	OK
Zip	:	74137-2719
Country	:	US
Telephone Number	:	918-749-6841
Fax Number	:	918-749-6859

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	08/12/2005
Last Update Date	:	07/08/2007

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