Provider Demographics
NPI:1578663472
Name:SONNER, JILL LIBERTY (DDS)
Entity Type:Individual
Prefix:MS
First Name:JILL
Middle Name:LIBERTY
Last Name:SONNER
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 1:3803 COMPUTER DR STE 200
Mailing Address - Street 2:
Mailing Address - City:RALEIGH
Mailing Address - State:NC
Mailing Address - Zip Code:27609-6525
Mailing Address - Country:US
Mailing Address - Phone:919-786-6766
Mailing Address - Fax:
Practice Address - Street 1:3803 COMPUTER DR STE 200
Practice Address - Street 2:
Practice Address - City:RALEIGH
Practice Address - State:NC
Practice Address - Zip Code:27609-6525
Practice Address - Country:US
Practice Address - Phone:919-786-6766
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-09-22
Last Update Date:2021-03-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC78531223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice