Provider Demographics
NPI:1407931199
Name:DILLON, BRIAN JOSEPH (DDS)
Entity Type:Individual
Prefix:DR
First Name:BRIAN
Middle Name:JOSEPH
Last Name:DILLON
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:BRIAN
Other - Middle Name:J
Other - Last Name:DILLON
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:DDS
Mailing Address - Street 1:8301 161ST AVE NE
Mailing Address - Street 2:#305
Mailing Address - City:REDMOND
Mailing Address - State:WA
Mailing Address - Zip Code:98052
Mailing Address - Country:US
Mailing Address - Phone:425-885-5529
Mailing Address - Fax:425-885-2024
Practice Address - Street 1:8301 161ST AVE NE
Practice Address - Street 2:#305
Practice Address - City:REDMOND
Practice Address - State:WA
Practice Address - Zip Code:98052
Practice Address - Country:US
Practice Address - Phone:425-885-5529
Practice Address - Fax:425-885-2024
Is Sole Proprietor?:No
Enumeration Date:2006-10-25
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WA7260122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist