Organization
RIVERTON DENTAL ARTS P.C.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. GARY S LILLIE D.M.D. (V.PRES)
(856) 829-1598
Entity
Organization
Contact information
Practice address
12 BROAD ST, RIVERTON, NJ 08077-1301
(856) 829-1598
Mailing address
12 BROAD ST, RIVERTON, NJ 08077-1301
(856) 829-1598
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
DI15124
NJ
Other
Enumeration date
01/20/2007
Last updated
08/22/2020
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