| NPI | 1619425337 |
|---|---|
| Other Name | JAMES E LILLENBERG DDS INC |
| Entity Type | Organization |
| Authorized Contact | JAMES EDWARD LILLENBERG President/Owner 314-842-0256 |
| Organization Subpart ? | No |
| Primary Taxonomy | 305S00000X Point of Service (Licence: MO 012959) |
| Enumeration Date | 2016-09-12 |
| Last Update Date | 2016-09-28 |