Individual
DR. GREGORY JAMES NICORATA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
6741 W 127TH ST, PALOS HEIGHTS, IL 60463-2253
(708) 702-7776
Mailing address
6741 W 127TH ST, PALOS HEIGHTS, IL 60463-2253
(708) 448-1125
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
019.033852
IL
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
03/17/2022
Last updated
06/28/2022
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