Individual
MARKO ILICH
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
32 GARDEN LN, PALMYRA, VA 22963-4282
(434) 510-7261
Mailing address
32 GARDEN LN, PALMYRA, VA 22963-4282
(434) 510-7261
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
0401418481
VA
Other
Enumeration date
06/06/2023
Last updated
07/21/2025
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