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General NPI Number Information
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NPI Number | 1467580621
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Entity Type | Individual
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Provider Name | DR. ADRIANA VERONICA BREBAN
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Gender | Female
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Dates
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Enumeration Date | 03/01/2007
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 5030 N MARINE DR #2201
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City | CHICAGO
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State | IL
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Zip | 60640-3267
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Country | US
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Telephone | 773-506-0650
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Fax |
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Provider Business Mailing Address
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Address Line | 5030 N MARINE DR APT 2201 #2201
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City | CHICAGO
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State | IL
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Zip | 60640-3386
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Country | US
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Telephone | 773-506-0650
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 122300000X
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Taxonomy Name | Dentist
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License Number |
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License Number State | IL
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