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General NPI Number Information
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NPI Number | 1134506272
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Entity Type | Individual
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Provider Name | PRINCE DHILLON DMD, MD
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Gender | Male
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Dates
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Enumeration Date | 04/27/2015
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Last Update Date | 08/30/2019
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Provider Practice Location Address
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Address Line | 1400 PELHAM PKWY S
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City | BRONX
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State | NY
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Zip | 10461-1138
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Country | US
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Telephone | 267-237-1890
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Fax |
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Provider Business Mailing Address
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Address Line | 3450 WAYNE AVE APT 10M
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City | BRONX
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State | NY
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Zip | 10467-2511
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Country | US
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Telephone | 267-237-1890
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1223S0112X
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Taxonomy Name | Oral and Maxillofacial Surgery (Dentist)
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License Number | 060667
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License Number State | NY
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