Provider Demographics
NPI:1285708602
Name:LITVIN, PAUL E (DDS)
Entity type:Individual
Prefix:DR
First Name:PAUL
Middle Name:E
Last Name:LITVIN
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:234 W FOX HILL DR
Mailing Address - Street 2:
Mailing Address - City:BUFFALO GROVE
Mailing Address - State:IL
Mailing Address - Zip Code:60089-7708
Mailing Address - Country:US
Mailing Address - Phone:847-537-2180
Mailing Address - Fax:847-325-5049
Practice Address - Street 1:701 W GOLF RD
Practice Address - Street 2:SUITE 1
Practice Address - City:MT PROSPECT
Practice Address - State:IL
Practice Address - Zip Code:60056-4169
Practice Address - Country:US
Practice Address - Phone:847-434-5878
Practice Address - Fax:847-593-0376
Is Sole Proprietor?:No
Enumeration Date:2006-11-17
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL1223P0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223P0300XDental ProvidersDentistPeriodontics