Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 1223X0400X | Orthodontists | 5915 | NC |
NPI | 1053524306 |
---|---|
Provider Name | Brett Joseph Hill |
First Address | Cornelius, NC 28031-8111 |
Second Address | Cornelius, NC 28031-8111 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 07/05/2007 |
Last Update Date | 08/07/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
1457437436 | ORGANIZATIONAL NPI (01) | NC |