Provider Demographics
NPI:1396563789
Name:DILLON, DANIELLE LEIGH (DDS)
Entity type:Individual
Prefix:DR
First Name:DANIELLE
Middle Name:LEIGH
Last Name:DILLON
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:DANIELLE
Other - Middle Name:LEIGH
Other - Last Name:DILLON-SEEGER
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:1684 WOODS DR
Mailing Address - Street 2:
Mailing Address - City:SAINT ALBANS
Mailing Address - State:WV
Mailing Address - Zip Code:25177-8865
Mailing Address - Country:US
Mailing Address - Phone:304-206-1094
Mailing Address - Fax:
Practice Address - Street 1:2150 CHILDRESS RD APT 2
Practice Address - Street 2:
Practice Address - City:ALUM CREEK
Practice Address - State:WV
Practice Address - Zip Code:25003-9546
Practice Address - Country:US
Practice Address - Phone:304-756-9464
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-10-02
Last Update Date:2024-10-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WV47261223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice