Provider Demographics
NPI:1588754915
Name:HILL, STEPHEN C (DDS)
Entity type:Individual
Prefix:DR
First Name:STEPHEN
Middle Name:C
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 1:1001 BUCKINGHAM RD
Mailing Address - Street 2:SUITE 106
Mailing Address - City:RICHARDSON
Mailing Address - State:TX
Mailing Address - Zip Code:75081-5850
Mailing Address - Country:US
Mailing Address - Phone:972-644-8500
Mailing Address - Fax:972-644-0104
Practice Address - Street 1:1001 BUCKINGHAM RD
Practice Address - Street 2:SUITE 106
Practice Address - City:RICHARDSON
Practice Address - State:TX
Practice Address - Zip Code:75081-5850
Practice Address - Country:US
Practice Address - Phone:972-644-8500
Practice Address - Fax:972-644-0104
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-14
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX105991223S0112X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223S0112XDental ProvidersDentistOral and Maxillofacial Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX87D028OtherBCBS PROVIDER NUMBER
TXT13835Medicare UPIN