DR. John Barry Tillis, D.M.D.

NPI #1790728236 in Rockford, Illinois

Provider Information

NPI Number: 1790728236
Entity Type: Individual
Name: DR. John Barry Tillis, D.M.D.
Gender: Not Specified
Sole Proprietor: Yes
Primary Specialty: Dentist
Credential: D.M.D.
Enumeration Date: Jun 13, 2006
Last Updated: Aug 28, 2007

Practice Location

Address: 7117 CRIMSON RIDGE DR
Address 2: SUITE 5
City: Rockford
State: Illinois
ZIP Code: 61107-6208
Phone: (815) 395-0327

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Dentist	122300000X	Primary

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