Provider Demographics
NPI:1225151798
Name:BILES, JILL MARIE (DDS)
Entity Type:Individual
Prefix:
First Name:JILL
Middle Name:MARIE
Last Name:BILES
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:900 S MAIN ST
Mailing Address - Street 2:201
Mailing Address - City:LONGMONT
Mailing Address - State:CO
Mailing Address - Zip Code:80501-6466
Mailing Address - Country:US
Mailing Address - Phone:303-776-9701
Mailing Address - Fax:303-776-0176
Practice Address - Street 1:900 S MAIN ST
Practice Address - Street 2:201
Practice Address - City:LONGMONT
Practice Address - State:CO
Practice Address - Zip Code:80501-6466
Practice Address - Country:US
Practice Address - Phone:303-776-9701
Practice Address - Fax:303-776-0176
Is Sole Proprietor?:No
Enumeration Date:2007-04-09
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO9174122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist