Individual
DR. MARY ROMAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
DDS
Contact information
Practice address
801 S PAULINA ST, CHICAGO, IL 60612-7210
(312) 996-7514
Mailing address
801 S PAULINA ST, RM 304 D, CHICAGO, IL 60612-7210
(312) 996-7514
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
019029510
IL
Other
Enumeration date
01/16/2014
Last updated
02/21/2014
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