Dille Dental, PLLC

Organization Active NPI Dentist · Cambridge, ID

NPI 1952749335 · NPPES record last updated Jun 7, 2013

Key facts

NPI
1952749335
Entity type
Organization (NPI type 2)
Primary specialty
Dentist 122300000X
License
D4240 (ID)
Legal business name
DILLE DENTAL, PLLC
Practice address
90 S Superior Street
Cambridge, ID 83610
Phone
(208) 257-4522
Fax
(208) 257-4523
NPI assigned
Jun 7, 2013
Organization subpart
Yes
Parent organization (as reported)
DILLE DENTAL, PLLC

Authorized official

Name
Bryan J Dille, DDS
Title
Owner/Dentist
Phone
(208) 549-1732

Corporate family (same tax ID) 1

Organizations that report the same tax identification number in the National Provider Directory.

National Provider Directory

Tax ID family
Dille Dental PLLC (2 organizations share this tax ID)
Part of
Dille Dental PLLC

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist
Group: 193200000X MULTI-SPECIALTY GROUP
122300000X D4240 ID Yes

Addresses

Primary practice location

90 S Superior Street
Cambridge, ID 83610

Mailing address

PO Box 369
Cambridge, ID 83610-0369
Phone (208) 257-4522

Other providers in Cambridge, ID

All providers in Cambridge, ID · Dentist in Idaho

Sources for this page

Verify at the official NPI Registry.