Provider Demographics
NPI:1053377994
Name:HILLS, ELLIOTT B (DDS)
Entity type:Individual
Prefix:
First Name:ELLIOTT
Middle Name:B
Last Name:HILLS
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:PO BOX 1019
Mailing Address - Street 2:
Mailing Address - City:CAMDEN
Mailing Address - State:TN
Mailing Address - Zip Code:38320-1019
Mailing Address - Country:US
Mailing Address - Phone:731-584-5211
Mailing Address - Fax:731-584-5245
Practice Address - Street 1:110 N FORREST AVE
Practice Address - Street 2:
Practice Address - City:CAMDEN
Practice Address - State:TN
Practice Address - Zip Code:38320-2062
Practice Address - Country:US
Practice Address - Phone:731-584-5211
Practice Address - Fax:731-584-5245
Is Sole Proprietor?:Yes
Enumeration Date:2006-04-20
Last Update Date:2012-09-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TNDS 38751223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice