Individual
DR. MELVIN LAUREL DILLARD III
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
1964 DEMPSTER ST, EVANSTON, IL 60202-1016
(773) 608-9334
Mailing address
1964 DEMPSTER ST, EVANSTON, IL 60202-1016
(773) 608-9334
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
019.028872
IL
122300000X
Dentist
DEN1000944
DC
1223X0400X
Orthodontics and Dentofacial Orthopedics Dentistry
Primary
021002650
IL
1223X0400X
Orthodontics and Dentofacial Orthopedics Dentistry
6916-15
WI
Other
Enumeration date
06/18/2012
Last updated
05/07/2015
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