Provider Demographics
NPI:1881354249
Name:TODD HILBURN DDS, LLC
Entity type:Organization
Organization Name:TODD HILBURN DDS, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DOCTOR/OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:LARRY
Authorized Official - Middle Name:TODD
Authorized Official - Last Name:HILBURN
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:318-340-1003
Mailing Address - Street 1:1107 GLENWOOD DR
Mailing Address - Street 2:
Mailing Address - City:WEST MONROE
Mailing Address - State:LA
Mailing Address - Zip Code:71291-5503
Mailing Address - Country:US
Mailing Address - Phone:318-340-1003
Mailing Address - Fax:318-340-1006
Practice Address - Street 1:1107 GLENWOOD DR
Practice Address - Street 2:
Practice Address - City:WEST MONROE
Practice Address - State:LA
Practice Address - Zip Code:71291-5503
Practice Address - Country:US
Practice Address - Phone:318-340-1003
Practice Address - Fax:318-340-1006
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-12-28
Last Update Date:2021-12-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Single Specialty