Provider Demographics
NPI:1801003108
Name:LILIKAS, MARINOS VASILIOU (DMD)
Entity Type:Individual
Prefix:DR
First Name:MARINOS
Middle Name:VASILIOU
Last Name:LILIKAS
Suffix:
Gender:M
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:588 BROADWAY
Mailing Address - Street 2:
Mailing Address - City:BAYONNE
Mailing Address - State:NJ
Mailing Address - Zip Code:07002-3826
Mailing Address - Country:US
Mailing Address - Phone:201-437-1177
Mailing Address - Fax:201-437-5121
Practice Address - Street 1:588 BROADWAY
Practice Address - Street 2:
Practice Address - City:BAYONNE
Practice Address - State:NJ
Practice Address - Zip Code:07002-3826
Practice Address - Country:US
Practice Address - Phone:201-437-1177
Practice Address - Fax:201-437-5121
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-17
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJDIO160871223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice