Individual
ALYSSA DILLON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DDS
Contact information
Practice address
25 INNOVATION DR, GREENVILLE, SC 29607-5394
(864) 210-9075
Mailing address
25 INNOVATION DR, GREENVILLE, SC 29607-5394
(864) 210-9075
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
9120
SC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
103042197
—
PA
01
—
DS040628
LICENSE
PA
Enumeration date
08/28/2015
Last updated
06/30/2023
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