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General NPI Number Information
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NPI Number | 1578631107
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Entity Type | Individual
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Provider Name | ANDREA NICHOLE TRATTNER RDH
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Gender | Female
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Dates
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Enumeration Date | 12/01/2006
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 55 E LOOP RD STE 201 GROVE DENTAL
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City | WHEATON
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State | IL
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Zip | 60187
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Country | US
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Telephone | 630-853-8899
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Fax |
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Provider Business Mailing Address
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Address Line | 6340 AMERICANA DR #918
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City | WILLOWBROOK
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State | IL
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Zip | 60527
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Country | US
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Telephone | 630-850-9046
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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 | 124Q00000X
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Taxonomy Name | Dental Hygienist
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License Number |
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License Number State | IL
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