Provider Demographics
NPI:1699970350
Name:DHILLON, RAKESH S (DMD)
Entity type:Individual
Prefix:DR
First Name:RAKESH
Middle Name:S
Last Name:DHILLON
Suffix:
Gender:M
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3115 A BRUSHY CREEK ROAD
Mailing Address - Street 2:
Mailing Address - City:GREER
Mailing Address - State:SC
Mailing Address - Zip Code:29650
Mailing Address - Country:US
Mailing Address - Phone:864-877-3631
Mailing Address - Fax:864-877-8545
Practice Address - Street 1:3115 A BRUSHY CREEK ROAD
Practice Address - Street 2:
Practice Address - City:GREER
Practice Address - State:SC
Practice Address - Zip Code:29650
Practice Address - Country:US
Practice Address - Phone:864-877-3631
Practice Address - Fax:864-877-8545
Is Sole Proprietor?:No
Enumeration Date:2007-06-20
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC34471223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice