Provider Demographics
NPI:1912054412
Name:BILLS, DANIEL A (DMD, MS)
Entity Type:Individual
Prefix:DR
First Name:DANIEL
Middle Name:A
Last Name:BILLS
Suffix:
Gender:M
Credentials:DMD, MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2001 LIBERTY PL
Mailing Address - Street 2:LAKESIDE BUSINESS PARK
Mailing Address - City:SICKLERVILLE
Mailing Address - State:NJ
Mailing Address - Zip Code:08081-5707
Mailing Address - Country:US
Mailing Address - Phone:856-875-4600
Mailing Address - Fax:
Practice Address - Street 1:2001 LIBERTY PL
Practice Address - Street 2:LAKESIDE BUSINESS PARK
Practice Address - City:SICKLERVILLE
Practice Address - State:NJ
Practice Address - Zip Code:08081-5707
Practice Address - Country:US
Practice Address - Phone:856-875-4600
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-05
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ22D1022502001223X0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223X0400XDental ProvidersDentistOrthodontics and Dentofacial Orthopedics