Individual
DR. GREGG RUSSELL DILLAWAY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.M.D.
Contact information
Practice address
30 COLPITTS RD, WESTON, MA 02493-1534
(781) 899-5084
(781) 642-0609
Mailing address
PO BOX 181, WESTON, MA 02493-0001
(781) 899-5084
(781) 642-0609
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
17525
MA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
17525
MA STATE LICENSE
MA
01
—
807
DELTA DENTAL PROVIDER
MA
01
—
X06467DI
BCBS PROVIDER
MA
Enumeration date
09/14/2006
Last updated
03/07/2023
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