Provider Demographics
NPI:1427403666
Name:SOCARRAS DIAZ, LILIEM (DMD)
Entity Type:Individual
Prefix:DR
First Name:LILIEM
Middle Name:
Last Name:SOCARRAS DIAZ
Suffix:
Gender:F
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1620 S CONGRESS AVE STE 102
Mailing Address - Street 2:
Mailing Address - City:PALM SPRINGS
Mailing Address - State:FL
Mailing Address - Zip Code:33461-2128
Mailing Address - Country:US
Mailing Address - Phone:617-770-0955
Mailing Address - Fax:
Practice Address - Street 1:1620 S CONGRESS AVE STE 102
Practice Address - Street 2:
Practice Address - City:PALM SPRINGS
Practice Address - State:FL
Practice Address - Zip Code:33461-2128
Practice Address - Country:US
Practice Address - Phone:561-508-5930
Practice Address - Fax:561-653-1238
Is Sole Proprietor?:Yes
Enumeration Date:2016-04-25
Last Update Date:2020-07-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLDN229811223P0221X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223P0221XDental ProvidersDentistPediatric Dentistry