DR. Dominica Portman, D.M.D.

NPI #1396115283 in North Chicago, Illinois

Provider Information

NPI Number: 1396115283
Entity Type: Individual
Name: DR. Dominica Portman, D.M.D.
Gender: Not Specified
Sole Proprietor: No
Primary Specialty: Dentist
Credential: D.M.D.
Enumeration Date: Oct 5, 2015
Last Updated: Oct 5, 2015

Practice Location

Address: 3001 GREEN BAY ROAD
City: North Chicago
State: Illinois
ZIP Code: 60064
Phone: (847) 688-1900

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Dentist	122300000X	Primary

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