Individual
BYRON THEODORE HILDAHL
Active
Sole proprietor
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
707 W FRANCIS AVE, SUITE 200, SPOKANE, WA 99205-6401
(509) 327-3368
(509) 325-2712
Mailing address
707 W FRANCIS AVE, SUITE 200, SPOKANE, WA 99205-6401
(509) 327-3368
(509) 325-2712
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
3818
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
136630
BCBS PROVIDER NUMBER
WA
01
—
3517
DELTA PROVIDER NUMBER
WA
05
—
5012059
—
WA
01
—
804444
UNITED CON. PROVIDER NUM.
WA
Enumeration date
05/05/2006
Last updated
07/09/2007
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