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Individual

LINORA NISSAN

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
DMD

Contact information

Practice address
3939 W FULLERTON AVE, CHICAGO, IL 60647-2243
(773) 235-0000
Mailing address
8640 WAUKEGAN RD UNIT 531, MORTON GROVE, IL 60053-2226
(847) 648-6245

Taxonomy

Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
019.032721
IL

Other

Enumeration date
10/29/2020
Last updated
10/29/2020
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