Provider Demographics
NPI:1770949216
Name:DILLON, SCOTT (BA)
Entity type:Individual
Prefix:MR
First Name:SCOTT
Middle Name:
Last Name:DILLON
Suffix:
Gender:M
Credentials:BA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3896 SWENSON ST
Mailing Address - Street 2:APARTMENT #1204-A
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89119-7408
Mailing Address - Country:US
Mailing Address - Phone:732-904-9522
Mailing Address - Fax:732-904-9522
Practice Address - Street 1:3896 SWENSON ST
Practice Address - Street 2:APARTMENT #1204-A
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89119-7408
Practice Address - Country:US
Practice Address - Phone:732-904-9522
Practice Address - Fax:732-904-9522
Is Sole Proprietor?:No
Enumeration Date:2016-01-14
Last Update Date:2016-01-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator