Provider Demographics
NPI:1457592545
Name:JOVA, PAULINA ANA (DDS)
Entity Type:Individual
Prefix:DR
First Name:PAULINA
Middle Name:ANA
Last Name:JOVA
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5154 N CLARK ST
Mailing Address - Street 2:SUITE. 221
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60640-2828
Mailing Address - Country:US
Mailing Address - Phone:773-561-7116
Mailing Address - Fax:
Practice Address - Street 1:5154 N CLARK ST
Practice Address - Street 2:SUITE. 221
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60640-2828
Practice Address - Country:US
Practice Address - Phone:773-561-7116
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-03-18
Last Update Date:2009-03-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL0190206781223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice