Individual
TARA MARIE DILLOW
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
354TH MDOS/SGOD, 2630 CENTRAL AVE STE 1M07, EIELSON AFB, AK 99702-2397
(907) 377-6767
Mailing address
354TH MDOS/SGOD, 2630 CENTRAL AVE STE 1M07, EIELSON AFB, AK 99702-2397
(907) 377-6767
Taxonomy
Speciality
Code
Description
License number
State
126800000X
Dental Assistant
Primary
—
—
Other
Enumeration date
12/26/2019
Last updated
12/26/2019
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