Provider Demographics
NPI:1730438441
Name:ILIE, SORINA PAULA (DDS)
Entity type:Individual
Prefix:MRS
First Name:SORINA
Middle Name:PAULA
Last Name:ILIE
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:817 SUN VALLEY WAY
Mailing Address - Street 2:
Mailing Address - City:FLORHAM PARK
Mailing Address - State:NJ
Mailing Address - Zip Code:07932-3046
Mailing Address - Country:US
Mailing Address - Phone:510-468-7889
Mailing Address - Fax:
Practice Address - Street 1:817 SUN VALLEY WAY
Practice Address - Street 2:
Practice Address - City:FLORHAM PARK
Practice Address - State:NJ
Practice Address - Zip Code:07932-3046
Practice Address - Country:US
Practice Address - Phone:510-468-7889
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-09-10
Last Update Date:2012-09-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ22DI025177001223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice