Organization
BILL C.W. DILL III DDS
Active
Organization subpart
No
Provider details
NPI number
Authorized official
BILL CW DILL III DDS (OWNER/DENTIST)
(479) 443-4440
Entity
Organization
Contact information
Practice address
2646 E JOYCE BLVD STE 1, FAYETTEVILLE, AR 72703-4435
(479) 443-4440
(479) 443-4450
Mailing address
2646 E JOYCE BLVD STE 1, FAYETTEVILLE, AR 72703-4435
(479) 443-4440
(479) 443-4450
Taxonomy
Speciality
Code
Description
License number
State
261QD0000X
Dental Clinic/Center
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
160839608
—
AR
01
—
58122
BLUE CROSS BLUE SHIELD
AR
Enumeration date
07/24/2009
Last updated
07/24/2009
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