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General NPI Number Information
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NPI Number | 1528485000
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Entity Type | Organization
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Legal Business Name | AURORA L CICEOVAN DDS,PC
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Dates
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Enumeration Date | 03/24/2014
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Last Update Date | 03/24/2014
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Provider Practice Location Address
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Address Line | 1530 E DUNDEE RD SUITE 300
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City | PALATINE
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State | IL
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Zip | 60074-8325
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Country | US
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Telephone | 847-358-8080
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Fax |
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Provider Business Mailing Address
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Address Line | 803 KENNICOTT PL
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City | MOUNT PROSPECT
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State | IL
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Zip | 60056-4072
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Country | US
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Telephone | 847-806-6765
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. AURORA L CICEOVAN
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Credential | DDS
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Telephone | 847-358-8080
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1223G0001X
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Taxonomy Name | General Practice Dentistry
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License Number | 019024038
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License Number State | IL
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