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Individual
DR. JASON SCOTT LILLY
Active
Individual
DR. JASON SCOTT LILLY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DMD
Taxonomy
Speciality
Code
Description
License number
State
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
11096
KY
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
9847
TN
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
Primary
TN9847
TN
390200000X
Student in an Organized Health Care Education/Training Program
—
NULL
Other
Enumeration date
05/18/2010
Last updated
06/24/2024
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