MEDICARE: RYAN WILLIAM HILL

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	D9635	OR
2	390200000X	Student in an Organized Health Care Education/Training Program
3	1223G0001X	General Practice Dentistry	08916	IA

General Provider Information

NPI Number	:	1447570262
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	RYAN WILLIAM HILL

Provider Business Mailing Address
First Line	:	907 BANK CT
Second Line	:
City	:	CENTER POINT
State	:	IA
Zip	:	52213-9337
Country	:	US
Telephone Number	:	319-325-1258
Fax Number	:

Provider Business Practice Location Address
First Line	:	907 BANK CT
Second Line	:
City	:	CENTER POINT
State	:	IA
Zip	:	52213-9337
Country	:	US
Telephone Number	:	319-849-1171
Fax Number	:

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

Provider Enumeration Date	:	06/03/2010
Last Update Date	:	01/28/2022

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Directions to “ RYAN WILLIAM HILL ” Practice Location

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