Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 1223D0004X | Dentist Anesthesiologist | 9105 | NC |
NPI | 1447501093 |
---|---|
Provider Name | Dr. Dillon Tyson Atwood |
First Address | Chapel Hill, NC 27517-4068 |
Second Address | Chapel Hill, NC 27517-4068 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 23/09/2012 |
Last Update Date | 22/11/2013 |