Douglas W. Tillery DDS

NPI 1033120001 - Dentist - 122300000X

NPI Details
NPI 1033120001
Gender Male
Enumeration Date 08/11/2006
Last Updated 07/08/2007
Entity Type Individual
Active Over 10 years ago
Practice Location
1508 W 10TH ST
LAUREL MS, 39440-2668, US
Phone (601) 428-6093
Fax (601) 428-6096
Business Location
1508 W 10TH ST
LAUREL MS, 39440-2668, US
Phone (601) 428-6093
Fax (601) 428-6096
Toxanomy
Taxonomy Code 122300000X
License State Mississippi
License Number MS133268
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According to our database, Douglas W. Tillery DDS NPI is 1033120001, taxonomy code is 122300000X and license number is MS133268, license state is located at Mississippi. Douglas W. Tillery DDS physically located at 1508 W 10th St, Laurel MS, 39440-2668. NPI Number Douglas W. Tillery DDS has the Individual type.

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1033120001 NPI number is provided on an as is basis without warranty of any kind. 1033120001 is maintained by the National Plan & Provider Enumeration System. The contents of Douglas W. Tillery DDS are for informational purposes only.