Provider Demographics
NPI:1922143759
Name:LILY W ENG OLIVER, DDS, PLLC
Entity Type:Organization
Organization Name:LILY W ENG OLIVER, DDS, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:LILY
Authorized Official - Middle Name:W
Authorized Official - Last Name:ENG
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:212-233-5153
Mailing Address - Street 1:101 LAFAYETTE ST
Mailing Address - Street 2:FL 9
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10013-4165
Mailing Address - Country:US
Mailing Address - Phone:212-233-5153
Mailing Address - Fax:212-842-5300
Practice Address - Street 1:101 LAFAYETTE ST
Practice Address - Street 2:FL 9
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10013-4165
Practice Address - Country:US
Practice Address - Phone:212-233-5153
Practice Address - Fax:212-842-8042
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-20
Last Update Date:2015-12-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY0452791223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Multi-Specialty