| Lilly Family Dentistry, P.c. | |
|
2100 Indian Hills Dr Sioux City IA 51104-1604 | |
| (712) 239-5125 | |
| (712) 239-2275 |
| Full Name | Lilly Family Dentistry, P.c. |
|---|---|
| Speciality | Dentist - General Practice |
| Location | 2100 Indian Hills Dr, Sioux City, Iowa |
| Authorized Official Name and Position | Kevin R. Lilly (OWNER) |
| Authorized Official Contact | 7122395125 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Lilly Family Dentistry, P.c. 2100 Indian Hills Dr Sioux City IA 51104-1604 Ph: (712) 239-5125 | Lilly Family Dentistry, P.c. 2100 Indian Hills Dr Sioux City IA 51104-1604 Ph: (712) 239-5125 |
| NPI Number | 1770661951 |
|---|---|
| Provider Enumeration Date | 11/02/2006 |
| Last Update Date | 08/22/2020 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1770661951 | NPI | - | NPPES |
| 1106369 | Medicaid | IA |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223G0001X | Dentist - General Practice | 7577 (Iowa) | Primary |
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