Provider Demographics
NPI:1447501093
Name:ATWOOD, DILLON TYSON (DDS)
Entity type:Individual
Prefix:DR
First Name:DILLON
Middle Name:TYSON
Last Name:ATWOOD
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 1:1408 OAK TREE DR
Mailing Address - Street 2:
Mailing Address - City:CHAPEL HILL
Mailing Address - State:NC
Mailing Address - Zip Code:27517-4068
Mailing Address - Country:US
Mailing Address - Phone:336-456-1666
Mailing Address - Fax:
Practice Address - Street 1:1408 OAK TREE DR
Practice Address - Street 2:
Practice Address - City:CHAPEL HILL
Practice Address - State:NC
Practice Address - Zip Code:27517-4068
Practice Address - Country:US
Practice Address - Phone:336-456-1666
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-09-23
Last Update Date:2013-11-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC91051223D0004X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223D0004XDental ProvidersDentistDental Anesthesiology