Provider Demographics
NPI:1467580621
Name:BREBAN, ADRIANA VERONICA
Entity Type:Individual
Prefix:DR
First Name:ADRIANA
Middle Name:VERONICA
Last Name:BREBAN
Suffix:
Gender:F
Credentials:
Other - Prefix:DR
Other - First Name:ADRIANA
Other - Middle Name:VERONICA
Other - Last Name:GIURGIU
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:
Mailing Address - Street 1:5030 N MARINE DR APT 2201
Mailing Address - Street 2:#2201
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60640-3386
Mailing Address - Country:US
Mailing Address - Phone:773-506-0650
Mailing Address - Fax:
Practice Address - Street 1:5030 N MARINE DR
Practice Address - Street 2:#2201
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60640-3267
Practice Address - Country:US
Practice Address - Phone:773-506-0650
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-03-01
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist