Organization
DR PAUL RUSSELL A NICOTRA DDS LTD
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. PAUL R A NICOTRA SR. DDS (PRES)
(847) 358-4700
Entity
Organization
Contact information
Practice address
135 W JOHNSON ST, STE #3, PALATINE, IL 60067
(847) 358-4700
(847) 358-8625
Mailing address
135 W JOHNSON ST, STE #3, PALATINE, IL 60067
(847) 358-4700
(847) 358-8625
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
01913082
IL
Other
Enumeration date
10/19/2007
Last updated
10/19/2007
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