Provider Demographics
NPI:1801199815
Name:CHRISTOPHER DILLON DDS PLLC
Entity Type:Organization
Organization Name:CHRISTOPHER DILLON DDS PLLC
Other - Org Name:PARKCHESTER FAMILY DENTAL
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:CHRISTOPHER
Authorized Official - Middle Name:J
Authorized Official - Last Name:DILLON
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:718-863-0200
Mailing Address - Street 1:64 METROPOLITAN OVAL
Mailing Address - Street 2:SUITE 9
Mailing Address - City:BRONX
Mailing Address - State:NY
Mailing Address - Zip Code:10462-6630
Mailing Address - Country:US
Mailing Address - Phone:718-863-0200
Mailing Address - Fax:718-863-0100
Practice Address - Street 1:64 METROPOLITAN OVAL
Practice Address - Street 2:SUITE 9
Practice Address - City:BRONX
Practice Address - State:NY
Practice Address - Zip Code:10462-6630
Practice Address - Country:US
Practice Address - Phone:718-863-0200
Practice Address - Fax:718-863-0100
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-12-13
Last Update Date:2010-12-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY0438591223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty