Provider Demographics
NPI:1699518282
Name:RAMIREZ, LILY (DMD)
Entity type:Individual
Prefix:
First Name:LILY
Middle Name:
Last Name:RAMIREZ
Suffix:
Gender:F
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:218 OVERLOOK DR
Mailing Address - Street 2:
Mailing Address - City:STROUDSBURG
Mailing Address - State:PA
Mailing Address - Zip Code:18360-6851
Mailing Address - Country:US
Mailing Address - Phone:570-856-1512
Mailing Address - Fax:
Practice Address - Street 1:1006 A ST
Practice Address - Street 2:
Practice Address - City:GREELEY
Practice Address - State:CO
Practice Address - Zip Code:80631-2021
Practice Address - Country:US
Practice Address - Phone:970-352-0048
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-06-13
Last Update Date:2024-06-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CODEN.002060211223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice