Individual
DR. LILY E. CHA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DDS
Contact information
Practice address
201 SAN PEDRO DR SE, SUITE B-2 (505) 232-5437, ALBUQUERQUE, NM 87108-3009
(505) 232-5437
(505) 254-7649
Mailing address
201 W 8TH ST, SUITE 810, PUEBLO, CO 81003-3038
(719) 562-4447
(719) 583-1801
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
DD3586
NM
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
43507573
—
NM
Enumeration date
09/14/2011
Last updated
07/11/2012
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