Provider Demographics
NPI:1992914337
Name:PRESTON HOLLOW SPECIALISTS
Entity type:Organization
Organization Name:PRESTON HOLLOW SPECIALISTS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:BRODY
Authorized Official - Middle Name:
Authorized Official - Last Name:HILDEBRAND
Authorized Official - Suffix:
Authorized Official - Credentials:DDS,MS
Authorized Official - Phone:214-691-5621
Mailing Address - Street 1:8411 PRESTON RD
Mailing Address - Street 2:SUITE
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75225-5523
Mailing Address - Country:US
Mailing Address - Phone:214-691-5621
Mailing Address - Fax:214-691-4934
Practice Address - Street 1:8411 PRESTON RD
Practice Address - Street 2:SUITE
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75225-5523
Practice Address - Country:US
Practice Address - Phone:214-691-5621
Practice Address - Fax:214-691-4934
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-22
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Not Answered1223G0001XDental ProvidersDentistGeneral PracticeGroup - Multi-Specialty
Not Answered1223P0700XDental ProvidersDentistProsthodonticsGroup - Multi-Specialty
Not Answered1223X0400XDental ProvidersDentistOrthodontics and Dentofacial OrthopedicsGroup - Multi-Specialty