Individual
DR. KENT GEORGE HILLERY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
OD
Contact information
Practice address
3343 CENTER GROVE DRIVE, CLOCK TOWER WEST, DUBUQUE, IA 52003-5264
(563) 588-2093
(563) 588-0590
Mailing address
3343 CENTER GROVE DRIVE, CLOCK TOWER WEST, DUBUQUE, IA 52003-5264
(563) 588-2093
(563) 588-0590
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
1379
WI
152W00000X
Optometrist
Primary
1541
IA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0070771
—
IA
01
—
07575
BLUE CROSS
IA
Enumeration date
11/07/2006
Last updated
07/08/2007
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