Provider Demographics
NPI:1366594822
Name:HILL, TRACY JILL (DDS)
Entity type:Individual
Prefix:DR
First Name:TRACY
Middle Name:JILL
Last Name:HILL
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2211 MIDWESTERN PARKWAY
Mailing Address - Street 2:SUITE 5
Mailing Address - City:WICHITA FALLS
Mailing Address - State:TX
Mailing Address - Zip Code:76308-2388
Mailing Address - Country:US
Mailing Address - Phone:940-692-0321
Mailing Address - Fax:940-696-5039
Practice Address - Street 1:2211 MIDWESTERN PARKWAY
Practice Address - Street 2:SUITE 5
Practice Address - City:WICHITA FALLS
Practice Address - State:TX
Practice Address - Zip Code:76308-2388
Practice Address - Country:US
Practice Address - Phone:940-692-0321
Practice Address - Fax:940-696-5039
Is Sole Proprietor?:No
Enumeration Date:2007-01-17
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX19718122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist