Individual
DR. MICHAEL SHANE DILLLARD
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DMD
Contact information
Practice address
2400 WISTERIA DR STE D, SNELLVILLE, GA 30078-2689
(770) 979-7794
Mailing address
9492 GREENS MILL CT, LOGANVILLE, GA 30052-5265
(770) 264-7951
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
DN013709
GA
Other
Enumeration date
05/22/2008
Last updated
03/24/2011
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