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General NPI Number Information
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NPI Number | 1174746176
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Entity Type | Individual
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Provider Name | DOUGLAS KING DILLARD DDS
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Gender | Male
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Dates
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Enumeration Date | 04/10/2007
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Last Update Date | 10/24/2013
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Provider Practice Location Address
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Address Line | 6617 PRECINCT LINE RD SUITE 100
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City | NORTH RICHLAND HILLS
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State | TX
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Zip | 76182-4315
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Country | US
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Telephone | 817-595-2458
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Fax |
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Provider Business Mailing Address
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Address Line | 107 FOREST BROOK ST
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City | OAK LEAF
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State | TX
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Zip | 75154-6028
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Country | US
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Telephone | 469-766-8462
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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 | 1223G0001X
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Taxonomy Name | General Practice Dentistry
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License Number | 13737
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License Number State | TX
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