Provider Demographics
NPI:1689374688
Name:DILLMAN, RACHEL (RDH)
Entity Type:Individual
Prefix:
First Name:RACHEL
Middle Name:
Last Name:DILLMAN
Suffix:
Gender:F
Credentials:RDH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:585 WILLOW GROVE RD
Mailing Address - Street 2:
Mailing Address - City:WACO
Mailing Address - State:TX
Mailing Address - Zip Code:76712-2818
Mailing Address - Country:US
Mailing Address - Phone:703-343-5104
Mailing Address - Fax:
Practice Address - Street 1:9636 BARTLETT CIR STE 400
Practice Address - Street 2:
Practice Address - City:FORT WORTH
Practice Address - State:TX
Practice Address - Zip Code:76108-4455
Practice Address - Country:US
Practice Address - Phone:703-343-5104
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-03-08
Last Update Date:2023-03-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX23062124Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes124Q00000XDental ProvidersDental Hygienist