Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 1223X0400X | Orthodontists | DS018644L | PA |
NPI | 1063634533 |
---|---|
Provider Name | Dr. Frederick Jay Hill |
First Address | Paoli, PA 19301-1743 |
Second Address | Paoli, PA 19301-1743 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 03/05/2007 |
Last Update Date | 08/07/2007 |