Provider Demographics
NPI:1427174002
Name:HILLCROFT DENTAL CLINIC AND ASSOCIATES PC
Entity type:Organization
Organization Name:HILLCROFT DENTAL CLINIC AND ASSOCIATES PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:MR
Authorized Official - First Name:LAZARO
Authorized Official - Middle Name:
Authorized Official - Last Name:CHAVARRIA
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:713-272-9196
Mailing Address - Street 1:6655 HILLCROFT STREET
Mailing Address - Street 2:SUITE 206
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77081-4815
Mailing Address - Country:US
Mailing Address - Phone:713-272-9196
Mailing Address - Fax:713-272-9198
Practice Address - Street 1:6655 HILLCROFT STREET
Practice Address - Street 2:SUITE 206
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77081-4815
Practice Address - Country:US
Practice Address - Phone:713-272-9196
Practice Address - Fax:713-272-9198
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-22
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Not Answered1223G0001XDental ProvidersDentistGeneral PracticeGroup - Multi-Specialty
Not Answered1223P0221XDental ProvidersDentistPediatric DentistryGroup - Multi-Specialty
Not Answered1223X0400XDental ProvidersDentistOrthodontics and Dentofacial OrthopedicsGroup - Multi-Specialty