Organization
DILLON DERMATOLOGY LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
WILLIAM I DILLON MD (OWNER)
(419) 373-6046
Entity
Organization
Contact information
Practice address
1037 CONNEAUT AVE, SUITE 201, BOWLING GREEN, OH 43402-5301
(419) 373-6046
(419) 352-9048
Mailing address
1037 CONNEAUT AVE, SUITE 201, BOWLING GREEN, OH 43402-5301
(419) 373-6046
(419) 352-9048
Taxonomy
Speciality
Code
Description
License number
State
207N00000X
Dermatology Physician
Primary
35064057D
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1538337480
MEDICAL MUTUAL OF OHIO
OH
Enumeration date
02/13/2008
Last updated
05/28/2008
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