Individual
DR. MICHAEL JOSEPH LILLY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DMD
Contact information
Practice address
899 RENO DR, WAYLAND, MI 49348-1732
(269) 509-4155
Mailing address
1402 SILVER SPRINGS CT SE, CALEDONIA, MI 49316-8445
(989) 330-5243
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
2901600219
MI
Other
Enumeration date
07/08/2019
Last updated
07/08/2019
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