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General NPI Number Information
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NPI Number | 1063204717
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Entity Type | Organization
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Legal Business Name | LILY XU DDS
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Dates
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Enumeration Date | 05/20/2025
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Last Update Date | 05/30/2025
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Provider Practice Location Address
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Address Line | 4745 VOLUNTEER RD STE 302
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City | DAVIE
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State | FL
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Zip | 33330-2126
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Country | US
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Telephone | 954-530-5164
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Fax |
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Provider Business Mailing Address
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Address Line | 3888 CASCADE TER
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City | WESTON
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State | FL
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Zip | 33332-2486
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Country | US
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Telephone | 248-330-7268
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | XIAOQIAN XU
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Credential |
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Telephone | 248-330-7268
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1223G0001X
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Taxonomy Name | General Practice Dentistry
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License Number |
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License Number State |
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