Individual
DR. DOMINICA PORTMAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
D.M.D.
Contact information
Practice address
3001 GREEN BAY ROAD, NORTH CHICAGO, IL 60064
(847) 688-1900
Mailing address
998 CHURCH STREET, UNIT 212, GLENVIEW, IL 60025
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
30.024585
OH
Other
Enumeration date
10/05/2015
Last updated
10/05/2015
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