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Individual

BRIAN LEE CILLA

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
DDS MS

Contact information

Practice address
3145 PRAIRIE ST SW, SUITE 104, GRANDVILLE, MI 49418-2098
(616) 531-1920
(616) 531-4275
Mailing address
3145 PRAIRIE ST SW, SUITE 104, GRANDVILLE, MI 49418-2098
(616) 531-1920
(616) 531-4275

Taxonomy

Speciality
Code
Description
License number
State
1223P0300X
Periodontics
Primary
290104700
MI

Other

Enumeration date
08/29/2006
Last updated
07/08/2007
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