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General NPI Number Information
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NPI Number | 1255427555
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Entity Type | Individual
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Provider Name | THOMAS J. LILLER DDS
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Gender | Male
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Dates
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Enumeration Date | 10/05/2006
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Last Update Date | 03/13/2008
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Provider Practice Location Address
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Address Line | 27476 DETROIT RD STE 205
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City | WESTLAKE
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State | OH
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Zip | 44145-2383
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Country | US
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Telephone | 440-250-8898
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Fax | 440-250-8979
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Provider Business Mailing Address
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Address Line | 27476 DETROIT RD STE 205
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City | WESTLAKE
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State | OH
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Zip | 44145-2383
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Country | US
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Telephone | 440-250-8898
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Fax | 440-250-8979
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 122300000X
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Taxonomy Name | Dentist
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License Number | 14848
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License Number State | OH
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