Individual
DR. TONY LEE PILGRIM
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
122 S. STATE ST., FALL CREEK, WI 54742-0066
(715) 877-2113
(715) 877-3495
Mailing address
6824 TOWER DR, EAU CLAIRE, WI 54703-8773
(715) 855-1105
(715) 855-1163
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
003104
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
33458700
—
WI
Enumeration date
01/19/2007
Last updated
07/08/2007
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