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General NPI Number Information
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NPI Number | 1942756184
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Entity Type | Individual
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Provider Name | ALISA DILL D.D.S.
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Gender | Female
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Dates
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Enumeration Date | 08/28/2016
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Last Update Date | 01/09/2022
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Provider Practice Location Address
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Address Line | 1701 FAIRWAY DR. #20
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City | ALVIN
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State | TX
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Zip | 77511
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Country | US
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Telephone | 281-331-0020
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Fax |
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Provider Business Mailing Address
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Address Line | 3660 RICHMOND AVE APT 476
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City | HOUSTON
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State | TX
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Zip | 77046-3613
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Country | US
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Telephone | 832-858-9764
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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 | 32157
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License Number State | TX
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Taxonomy #2
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Taxonomy Code | 122300000X
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Taxonomy Name | Dentist
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License Number | 32157
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License Number State | TX
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