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General NPI Number Information
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NPI Number | 1538109996
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Entity Type | Individual
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Provider Name | AURORA L CICEOVAN D,D,S
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Gender | Female
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Dates
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Enumeration Date | 06/07/2006
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Last Update Date | 09/10/2013
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Provider Practice Location Address
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Address Line | 1530 E DUNDEE RD STE 300
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City | PALATINE
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State | IL
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Zip | 60074-8301
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Country | US
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Telephone | 847-358-8080
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Fax | 847-358-8095
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Provider Business Mailing Address
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Address Line | 1530 E DUNDEE RD STE 300
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City | PALATINE
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State | IL
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Zip | 60074-8301
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Country | US
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Telephone | 847-358-8080
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Fax | 847-358-8095
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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 | 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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