Provider Demographics
NPI:1538110507
Name:DILLOW, RONALD W (DMD)
Entity Type:Individual
Prefix:DR
First Name:RONALD
Middle Name:W
Last Name:DILLOW
Suffix:
Gender:M
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2006 MALL ST
Mailing Address - Street 2:BLDG 1
Mailing Address - City:COLLINSVILLE
Mailing Address - State:IL
Mailing Address - Zip Code:62234-1831
Mailing Address - Country:US
Mailing Address - Phone:618-345-8333
Mailing Address - Fax:618-345-9772
Practice Address - Street 1:2006 MALL ST
Practice Address - Street 2:BLDG 1
Practice Address - City:COLLINSVILLE
Practice Address - State:IL
Practice Address - Zip Code:62234-1831
Practice Address - Country:US
Practice Address - Phone:618-345-8333
Practice Address - Fax:618-345-9772
Is Sole Proprietor?:No
Enumeration Date:2006-05-15
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL1223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice