Provider Demographics
NPI:1881889459
Name:DILL, YOUNG K (DMD)
Entity type:Individual
Prefix:
First Name:YOUNG
Middle Name:K
Last Name:DILL
Suffix:
Gender:F
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2538 ANTHEM VILLAGE DRIVE
Mailing Address - Street 2:SUITE 100
Mailing Address - City:HENDERSON
Mailing Address - State:NV
Mailing Address - Zip Code:89052-5551
Mailing Address - Country:US
Mailing Address - Phone:702-897-5560
Mailing Address - Fax:702-269-5511
Practice Address - Street 1:2538 ANTHEM VILLAGE DRIVE
Practice Address - Street 2:SUITE 100
Practice Address - City:HENDERSON
Practice Address - State:NV
Practice Address - Zip Code:89052-5551
Practice Address - Country:US
Practice Address - Phone:702-897-5560
Practice Address - Fax:702-269-5511
Is Sole Proprietor?:No
Enumeration Date:2007-09-07
Last Update Date:2007-09-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NV37101223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice