MEDICARE: DR. DAVID RUSSELL HILL DDS

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	1223P0700X	Prosthodontics	D7721	OR

General Provider Information

NPI Number	:	1831113646
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. DAVID RUSSELL HILL DDS

Provider Business Mailing Address
First Line	:	7807 NW 12TH AVE
Second Line	:
City	:	VANCOUVER
State	:	WA
Zip	:	98665-6031
Country	:	US
Telephone Number	:	360-566-9191
Fax Number	:

Provider Business Practice Location Address
First Line	:	7201 N INTERSTATE AVE
Second Line	:
City	:	PORTLAND
State	:	OR
Zip	:	97217-5523
Country	:	US
Telephone Number	:	503-286-6860
Fax Number	:

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

Provider Enumeration Date	:	07/26/2006
Last Update Date	:	07/08/2007

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