Organization
DILLE DENTAL, PLLC
Active
Parent organization
DILLE DENTAL, PLLC
Organization subpart
Yes
Provider details
NPI number
Legal business name
DILLE DENTAL, PLLC
Authorized official
BRYAN J DILLE DDS (OWNER/DENTIST)
(208) 549-1732
Entity
Organization
Contact information
Practice address
513 E MAIN ST, WEISER, ID 83672-2225
(208) 549-1732
Mailing address
513 E MAIN STREET, WEISER, ID 83672
(208) 549-1732
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
D4240
ID
Other
Enumeration date
06/07/2013
Last updated
06/07/2013
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