Marisa Lee Milligan

Dentist · Bloomington, IL

Individual Active NPI

NPI number 1508240763

Practice location

1404 Eastland Dr Ste 101
Bloomington, IL 61701-7904
Phone
(309) 663-4711
Fax
(309) 663-1854

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NPI record

NPI
1508240763
Entity type
Individual (Type 1)
Enumeration date
July 16, 2015
Last updated
July 16, 2015
Sole proprietor
No

Specialties & taxonomy codes

TaxonomyCodeLicenseState
Dentist Primary 122300000X 019030295 IL

About Marisa Milligan

Marisa Lee Milligan is a healthcare provider registered in the NPI registry with the primary taxonomy Dentist (code 122300000X). The practice location is 1404 Eastland Dr Ste 101, Bloomington, IL 61701-7904. The NPI number 1508240763 was assigned on July 16, 2015 and the record was last updated on July 16, 2015.

Marisa Milligan lists a license in the registry: #019030295 (IL) for Dentist. License numbers are self-reported to NPPES; verify them with the state licensing board.

Frequently asked questions

What is the NPI number of Marisa Lee Milligan?

The NPI number is 1508240763.

What is the phone number of Marisa Milligan?

The phone number listed for the practice location is (309) 663-4711.

Where is Marisa Milligan located?

1404 Eastland Dr Ste 101, Bloomington, IL 61701-7904.

What is the taxonomy code for Marisa Milligan?

The primary taxonomy code is 122300000X – Dentist.

Is this information correct?

All details come from the public NPPES registry. Providers can update their record at nppes.cms.hhs.gov; changes appear here after the next weekly update.

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