Individual
DR. NICHOLAS PAUL CUBAN II
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
D.D.S.
Contact information
Practice address
9116 COLUMBIA AVE, MUNSTER, IN 46321-2907
(219) 836-2525
(219) 836-2527
Mailing address
9116 COLUMBIA AVE, MUNSTER, IN 46321-2907
(219) 836-2525
(219) 836-2527
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
12006681
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
12006681
INDIANA DENTAL LICENSE NU
IN
Enumeration date
04/03/2007
Last updated
07/08/2007
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