Provider Demographics
NPI:1407943103
Name:MCALLISTER, LILLUS G (DDS)
Entity Type:Individual
Prefix:
First Name:LILLUS
Middle Name:G
Last Name:MCALLISTER
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 1:8310 STATE AVE
Mailing Address - Street 2:
Mailing Address - City:KANSAS CITY
Mailing Address - State:KS
Mailing Address - Zip Code:66112
Mailing Address - Country:US
Mailing Address - Phone:913-334-5225
Mailing Address - Fax:913-334-5222
Practice Address - Street 1:8310 STATE AVE
Practice Address - Street 2:
Practice Address - City:KANSAS CITY
Practice Address - State:KS
Practice Address - Zip Code:66112
Practice Address - Country:US
Practice Address - Phone:913-334-5225
Practice Address - Fax:913-334-5222
Is Sole Proprietor?:No
Enumeration Date:2006-10-06
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS66531223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice