Provider Demographics
NPI:1215985759
Name:HILL, JEREL D (DDS)
Entity type:Individual
Prefix:DR
First Name:JEREL
Middle Name:D
Last Name:HILL
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:205 N STATE ST
Mailing Address - Street 2:
Mailing Address - City:OREM
Mailing Address - State:UT
Mailing Address - Zip Code:84057-4745
Mailing Address - Country:US
Mailing Address - Phone:801-225-7110
Mailing Address - Fax:801-225-4001
Practice Address - Street 1:205 N STATE ST
Practice Address - Street 2:
Practice Address - City:OREM
Practice Address - State:UT
Practice Address - Zip Code:84057-4745
Practice Address - Country:US
Practice Address - Phone:801-225-7110
Practice Address - Fax:801-225-4001
Is Sole Proprietor?:No
Enumeration Date:2006-05-05
Last Update Date:2018-09-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT136284-99221223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice