Provider Demographics
NPI:1346345238
Name:LILJEMARK, WILLIAM FRANK (DDS, PLD)
Entity Type:Individual
Prefix:DR
First Name:WILLIAM
Middle Name:FRANK
Last Name:LILJEMARK
Suffix:
Gender:M
Credentials:DDS, PLD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1537 E 66TH ST # 100
Mailing Address - Street 2:
Mailing Address - City:RICHFIELD
Mailing Address - State:MN
Mailing Address - Zip Code:55423-2663
Mailing Address - Country:US
Mailing Address - Phone:612-866-3333
Mailing Address - Fax:612-866-2845
Practice Address - Street 1:1537 E 66TH ST # 100
Practice Address - Street 2:
Practice Address - City:RICHFIELD
Practice Address - State:MN
Practice Address - Zip Code:55423-2663
Practice Address - Country:US
Practice Address - Phone:612-866-3333
Practice Address - Fax:612-866-2845
Is Sole Proprietor?:No
Enumeration Date:2006-09-14
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN71051223X0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223X0400XDental ProvidersDentistOrthodontics and Dentofacial Orthopedics