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General NPI Number Information
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NPI Number | 1447857289
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Entity Type | Organization
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Legal Business Name | RICK & PAMELA DHILLON DMD - SDA LLC
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Dates
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Enumeration Date | 10/05/2020
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Last Update Date | 10/05/2020
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Provider Practice Location Address
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Address Line | 3115A BRUSHY CREEK RD
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City | GREER
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State | SC
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Zip | 29650-0903
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Country | US
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Telephone | 864-877-3631
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Fax |
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Provider Business Mailing Address
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Address Line | 3115A BRUSHY CREEK RD
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City | GREER
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State | SC
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Zip | 29650-0903
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Country | US
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Telephone | 864-877-3631
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Fax |
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Authorized Official
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Title or Position | CREDENTIALING SPECIALIST
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Name | JENNI TOMLINSON
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Credential |
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Telephone | 678-986-7116
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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 |
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License Number State |
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