Individual
DR. BRUCE W LILLY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
303 S GLENOAKS BLVD, SUITE 12, BURBANK, CA 91502-1319
(818) 846-2854
Mailing address
303 S GLENOAKS BLVD, SUITE 12, BURBANK, CA 91502-1319
(818) 846-2854
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
31310
CA
Other
Enumeration date
09/03/2006
Last updated
07/08/2007
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