Provider Demographics
NPI:1316005119
Name:DRAGOLICH, BILL E (DDS, MS)
Entity Type:Individual
Prefix:DR
First Name:BILL
Middle Name:E
Last Name:DRAGOLICH
Suffix:
Gender:M
Credentials:DDS, MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:5925 FOREST LN
Mailing Address - Street 2:STE 209
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75230-2712
Mailing Address - Country:US
Mailing Address - Phone:972-239-0327
Mailing Address - Fax:972-239-6464
Practice Address - Street 1:5925 FOREST LN
Practice Address - Street 2:STE 209
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75230-2712
Practice Address - Country:US
Practice Address - Phone:972-239-0327
Practice Address - Fax:972-239-6464
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-05
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX173301223P0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223P0300XDental ProvidersDentistPeriodontics