Individual
DR. CHARLES RANDLE DILLARD JR.
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DMD
Contact information
Practice address
4330 HIGHWAY 78 E, SUITE 200, JASPER, AL 35501-8905
(202) 295-2992
(205) 384-1291
Mailing address
4330 HIGHWAY 78 E, SUITE 200, JASPER, AL 35501-8905
(202) 295-2992
(205) 384-1291
Taxonomy
Speciality
Code
Description
License number
State
1223E0200X
Endodontics
Primary
4917
AL
Other
Enumeration date
03/21/2007
Last updated
07/09/2007
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