Provider Demographics
NPI:1922394196
Name:DILL, ANDREW NELSON (DDS)
Entity Type:Individual
Prefix:DR
First Name:ANDREW
Middle Name:NELSON
Last Name:DILL
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 1:1120 W HURON ST
Mailing Address - Street 2:
Mailing Address - City:ANN ARBOR
Mailing Address - State:MI
Mailing Address - Zip Code:48103-4220
Mailing Address - Country:US
Mailing Address - Phone:734-663-0100
Mailing Address - Fax:734-663-0100
Practice Address - Street 1:1120 W HURON ST
Practice Address - Street 2:
Practice Address - City:ANN ARBOR
Practice Address - State:MI
Practice Address - Zip Code:48103-4220
Practice Address - Country:US
Practice Address - Phone:734-663-0100
Practice Address - Fax:734-663-0100
Is Sole Proprietor?:No
Enumeration Date:2011-06-25
Last Update Date:2019-11-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI2901020400122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist