Provider Demographics
NPI:1275767535
Name:ESSEX ORAL SUGERY ASSOCIATES
Entity Type:Organization
Organization Name:ESSEX ORAL SUGERY ASSOCIATES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ORAL SURGEON
Authorized Official - Prefix:DR
Authorized Official - First Name:STEVEN
Authorized Official - Middle Name:ARTHUR
Authorized Official - Last Name:LILIEN
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:973-748-1515
Mailing Address - Street 1:364 FRANKLIN ST
Mailing Address - Street 2:
Mailing Address - City:BLOOMFIELD
Mailing Address - State:NJ
Mailing Address - Zip Code:07003-3446
Mailing Address - Country:US
Mailing Address - Phone:973-748-1515
Mailing Address - Fax:973-748-5216
Practice Address - Street 1:364 FRANKLIN ST
Practice Address - Street 2:
Practice Address - City:BLOOMFIELD
Practice Address - State:NJ
Practice Address - Zip Code:07003-3446
Practice Address - Country:US
Practice Address - Phone:973-748-1515
Practice Address - Fax:973-748-5216
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-05-14
Last Update Date:2009-05-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ22DI013298001223S0112X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223S0112XDental ProvidersDentistOral and Maxillofacial SurgeryGroup - Single Specialty