PAUL ETHAN WINE

CHICAGO, IL
NPI1316093438
Entity TypeIndividual
GenderMale
Sole Proprietor ?No
Primary Taxonomy1223G0001X Dentist, General Practice
(Licence: IL  019026138)
Enumeration Date2007-01-25
Last Update Date2007-07-08
Business Address
-- PAUL ETHAN WINE DDS
2632 W DIVISION ST
CHICAGO, IL 60622-2850
Phone number: 773-235-0980
Mailing Address
-- PAUL ETHAN WINE DDS
2632 W DIVISION ST
CHICAGO, IL 60622-2850
Phone number: 773-235-0980
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