Provider Demographics
NPI:1497916167
Name:DILLON, CRAIG M (DDS)
Entity Type:Individual
Prefix:DR
First Name:CRAIG
Middle Name:M
Last Name:DILLON
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2200 S MINNESOTA AVE
Mailing Address - Street 2:
Mailing Address - City:SIOUX FALLS
Mailing Address - State:SD
Mailing Address - Zip Code:57105-3798
Mailing Address - Country:US
Mailing Address - Phone:605-336-7850
Mailing Address - Fax:605-575-0446
Practice Address - Street 1:2200 S MINNESOTA AVE
Practice Address - Street 2:
Practice Address - City:SIOUX FALLS
Practice Address - State:SD
Practice Address - Zip Code:57105-3798
Practice Address - Country:US
Practice Address - Phone:605-336-7850
Practice Address - Fax:605-575-0446
Is Sole Proprietor?:Yes
Enumeration Date:2008-06-24
Last Update Date:2008-06-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SDM853122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist