Individual
DR. NICHOLAS PERETTI
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.D.S.
Contact information
Practice address
2160 S 1ST AVE, BLDG. 105 SUITE 1814, MAYWOOD, IL 60153-3328
(888) 584-7888
Mailing address
2160 S 1ST AVE, MAYWOOD, IL 60153-3328
(888) 584-7888
Taxonomy
Speciality
Code
Description
License number
State
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
Primary
17106
MT
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
03/27/2015
Last updated
07/08/2019
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