Individual
DR. BRYAN R. CICHON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
700 S RANDALL RD, SUITE #1, ST CHARLES, IL 60174-5916
(630) 587-2600
(630) 587-2605
Mailing address
1107 INDEPENDENCE AVE, ELBURN, IL 60119-7833
(630) 587-2600
(630) 587-2605
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
019-023433
IL
Other
Enumeration date
01/02/2007
Last updated
11/01/2012
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