Healthcare Provider Details

I. General information

NPI: 1780832519
Provider Name (Legal Business Name): MAURA JOSEPHINE VROMAN D.D.S., M.S.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: MAURA JOSEPHINE MILAS D.D.S., M.S.

II. Dates (important events)

Enumeration Date: 09/04/2008
Last Update Date: 11/25/2024
Certification Date: 11/25/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2131 1ST STREET A
MOLINE IL
61265-7745
US

IV. Provider business mailing address

2131 1ST STREET A
MOLINE IL
61265-7745
US

V. Phone/Fax

Practice location:
  • Phone: 309-797-0106
  • Fax: 309-797-0180
Mailing address:
  • Phone: 309-797-0106
  • Fax: 309-797-0180

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code1223X0400X
TaxonomyOrthodontics and Dentofacial Orthopedics Dentistry
License Number08686
License Number StateIA
# 2
Primary TaxonomyY
Taxonomy Code1223G0001X
TaxonomyGeneral Practice Dentistry
License Number019028210
License Number StateIL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: