Provider Demographics
NPI:1528373180
Name:VROMAN ORTHODONTICS, P.C.
Entity type:Organization
Organization Name:VROMAN ORTHODONTICS, P.C.
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER/ORTHODONTIST
Authorized Official - Prefix:DR
Authorized Official - First Name:MAURA
Authorized Official - Middle Name:J
Authorized Official - Last Name:VROMAN
Authorized Official - Suffix:
Authorized Official - Credentials:DDS, MS
Authorized Official - Phone:309-797-0106
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
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-08-07
Last Update Date:2010-08-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA08686261QD0000X
IL019028210261QD0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QD0000XAmbulatory Health Care FacilitiesClinic/CenterDental