Provider Demographics
NPI:1780832519
Name:VROMAN, MAURA JOSEPHINE (DDS, MS)
Entity Type:Individual
Prefix:DR
First Name:MAURA
Middle Name:JOSEPHINE
Last Name:VROMAN
Suffix:
Gender:F
Credentials:DDS, MS
Other - Prefix:DR
Other - First Name:MAURA
Other - Middle Name:JOSEPHINE
Other - Last Name:MILAS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:DDS, MS
Mailing Address - Street 1:2131 1ST STREET A
Mailing Address - Street 2:
Mailing Address - City:MOLINE
Mailing Address - State:IL
Mailing Address - Zip Code:61265-7745
Mailing Address - Country:US
Mailing Address - Phone:309-797-0106
Mailing Address - Fax:309-797-0180
Practice Address - Street 1:2131 1ST STREET A
Practice Address - Street 2:
Practice Address - City:MOLINE
Practice Address - State:IL
Practice Address - Zip Code:61265-7745
Practice Address - Country:US
Practice Address - Phone:309-797-0106
Practice Address - Fax:309-797-0180
Is Sole Proprietor?:Yes
Enumeration Date:2008-09-04
Last Update Date:2010-08-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA086861223X0400X
IL0190282101223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice
No1223X0400XDental ProvidersDentistOrthodontics and Dentofacial Orthopedics