MEDICARE: DR. CHARLES K HILL DMD, MS

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	122300000X	Dentist	4331	NV
2	1223X0400X	Orthodontics and Dentofacial Orthopedics Dentistry	S3-255	NV

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1700950243
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. CHARLES K HILL DMD, MS

Provider Business Mailing Address
First Line	:	9777 BERMUDA RD
Second Line	:	STE. 105
City	:	LAS VEGAS
State	:	NV
Zip	:	89183-3566
Country	:	US
Telephone Number	:	702-914-2364
Fax Number	:	702-914-2365

Provider Business Practice Location Address
First Line	:	9777 BERMUDA RD
Second Line	:	STE. 105
City	:	LAS VEGAS
State	:	NV
Zip	:	89183-3566
Country	:	US
Telephone Number	:	702-914-2364
Fax Number	:	702-914-2365

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

Provider Enumeration Date	:	11/17/2006
Last Update Date	:	06/12/2014

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