Provider Demographics
NPI:1225040595
Name:HILLTOP DENTISTS PC
Entity type:Organization
Organization Name:HILLTOP DENTISTS PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:JAMES
Authorized Official - Middle Name:HOWARD
Authorized Official - Last Name:FORD
Authorized Official - Suffix:
Authorized Official - Credentials:DMD
Authorized Official - Phone:810-631-4573
Mailing Address - Street 1:12265 N STATE RD
Mailing Address - Street 2:
Mailing Address - City:OTISVILLE
Mailing Address - State:MI
Mailing Address - Zip Code:48463-9794
Mailing Address - Country:US
Mailing Address - Phone:810-631-4573
Mailing Address - Fax:810-631-9600
Practice Address - Street 1:12265 N STATE RD
Practice Address - Street 2:
Practice Address - City:OTISVILLE
Practice Address - State:MI
Practice Address - Zip Code:48463-9794
Practice Address - Country:US
Practice Address - Phone:810-631-4573
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-13
Last Update Date:2025-11-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI29010125721223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty