Provider Demographics
NPI:1821017005
Name:FIAT, LILIA S (DMD)
Entity Type:Individual
Prefix:
First Name:LILIA
Middle Name:S
Last Name:FIAT
Suffix:
Gender:F
Credentials:DMD
Other - Prefix:
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Mailing Address - Street 1:435 NEWBURY STREET
Mailing Address - Street 2:SUITE 219
Mailing Address - City:DANVERS
Mailing Address - State:MA
Mailing Address - Zip Code:01923
Mailing Address - Country:US
Mailing Address - Phone:978-762-4455
Mailing Address - Fax:978-762-4466
Practice Address - Street 1:435 NEWBURY STREET
Practice Address - Street 2:SUITE 219
Practice Address - City:DANVERS
Practice Address - State:MA
Practice Address - Zip Code:01923
Practice Address - Country:US
Practice Address - Phone:978-762-4455
Practice Address - Fax:978-762-4466
Is Sole Proprietor?:No
Enumeration Date:2006-07-19
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MA176151223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice
Provider Identifiers
StateIdentifier IDID TypeIssuer
338790OtherUNITED CONCORDIA
X12094OtherBCBS OF MASSACHUSETTS