Provider Demographics
NPI:1740290287
Name:DIFRANCO, PAUL A JR (DDS)
Entity type:Individual
Prefix:DR
First Name:PAUL
Middle Name:A
Last Name:DIFRANCO
Suffix:JR
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:511 W TALCOTT RD
Mailing Address - Street 2:
Mailing Address - City:PARK RIDGE
Mailing Address - State:IL
Mailing Address - Zip Code:60068-5338
Mailing Address - Country:US
Mailing Address - Phone:947-318-7711
Mailing Address - Fax:947-318-9574
Practice Address - Street 1:511 W TALCOTT RD
Practice Address - Street 2:
Practice Address - City:PARK RIDGE
Practice Address - State:IL
Practice Address - Zip Code:60068-5338
Practice Address - Country:US
Practice Address - Phone:947-318-7711
Practice Address - Fax:947-318-9574
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-08
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL1223X0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223X0400XDental ProvidersDentistOrthodontics and Dentofacial Orthopedics