Provider Demographics
NPI:1083888358
Name:MAURICE A NETTER DDS LTD
Entity Type:Organization
Organization Name:MAURICE A NETTER DDS LTD
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:MAURICE
Authorized Official - Middle Name:A
Authorized Official - Last Name:NETTER
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:847-635-1176
Mailing Address - Street 1:9101 N GREENWOOD AVE
Mailing Address - Street 2:SUITE 305
Mailing Address - City:NILES
Mailing Address - State:IL
Mailing Address - Zip Code:60714-1499
Mailing Address - Country:US
Mailing Address - Phone:847-635-1176
Mailing Address - Fax:
Practice Address - Street 1:9101 N GREENWOOD AVE
Practice Address - Street 2:SUITE 305
Practice Address - City:NILES
Practice Address - State:IL
Practice Address - Zip Code:60714-1499
Practice Address - Country:US
Practice Address - Phone:847-635-1176
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-04-17
Last Update Date:2008-04-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Single Specialty