Provider Demographics
NPI:1053204586
Name:MAY, DYLLAN (DDS)
Entity type:Individual
Prefix:DR
First Name:DYLLAN
Middle Name:
Last Name:MAY
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 1:919 JOHNSON ST APT 7
Mailing Address - Street 2:
Mailing Address - City:LA CROSSE
Mailing Address - State:WI
Mailing Address - Zip Code:54601-5587
Mailing Address - Country:US
Mailing Address - Phone:585-503-8896
Mailing Address - Fax:
Practice Address - Street 1:1212 HORTON ST
Practice Address - Street 2:
Practice Address - City:LA CROSSE
Practice Address - State:WI
Practice Address - Zip Code:54601-6372
Practice Address - Country:US
Practice Address - Phone:608-925-3542
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-06-02
Last Update Date:2025-06-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI6001834-15122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist