Provider Demographics
NPI:1184631939
Name:DILLON, CHRISTOPHER J (DDS)
Entity type:Individual
Prefix:DR
First Name:CHRISTOPHER
Middle Name:J
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 1:64 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:
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:
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-02
Last Update Date:2012-11-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY0438591223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice