MEDICARE: BRYNNA DILLER DDS

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	1223G0001X	General Practice Dentistry	36383	TX

General Provider Information

NPI Number	:	1881203529
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	BRYNNA DILLER DDS

Provider Business Mailing Address
First Line	:	7649 HILLSIDE RD STE 100
Second Line	:
City	:	AMARILLO
State	:	TX
Zip	:	79119-8382
Country	:	US
Telephone Number	:	806-358-7633
Fax Number	:

Provider Business Practice Location Address
First Line	:	7649 HILLSIDE RD STE 100
Second Line	:
City	:	AMARILLO
State	:	TX
Zip	:	79119-8382
Country	:	US
Telephone Number	:	806-358-7633
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	07/29/2020
Last Update Date	:	07/29/2020

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Directions to “ BRYNNA DILLER DDS” Practice Location

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