Douglas W. Tillery, DDS

NPI #1033120001 in Laurel, Mississippi

Provider Information

NPI Number: 1033120001
Entity Type: Individual
Name: Douglas W. Tillery, DDS
Gender: Not Specified
Sole Proprietor: No
Primary Specialty: Dentist
Credential: DDS
Enumeration Date: Aug 11, 2006
Last Updated: Jul 8, 2007

Practice Location

Address: 1508 W 10TH ST
City: Laurel
State: Mississippi
ZIP Code: 39440-2668
Phone: (601) 428-6093

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Dentist	122300000X	Primary

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