Provider Demographics
NPI:1871646885
Name:COLIN, LILIA LORENA
Entity Type:Individual
Prefix:MS
First Name:LILIA
Middle Name:LORENA
Last Name:COLIN
Suffix:
Gender:F
Credentials:
Other - Prefix:DR
Other - First Name:HUGO
Other - Middle Name:
Other - Last Name:DOMINGUEZ
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:DDSPHD
Mailing Address - Street 1:PO BOX 3871
Mailing Address - Street 2:
Mailing Address - City:EL PASO
Mailing Address - State:TX
Mailing Address - Zip Code:79923-3871
Mailing Address - Country:US
Mailing Address - Phone:915-373-1852
Mailing Address - Fax:
Practice Address - Street 1:FCO. VILLA 229 INT 6
Practice Address - Street 2:
Practice Address - City:CD. JUAREZ
Practice Address - State:CHIHUAHUA
Practice Address - Zip Code:32000
Practice Address - Country:MX
Practice Address - Phone:656-632-3550
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-01-21
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX1009581122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist