Provider Demographics
NPI:1265959126
Name:TORITTO, NICOLA (DMD)
Entity type:Individual
Prefix:
First Name:NICOLA
Middle Name:
Last Name:TORITTO
Suffix:
Gender:M
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:418 E ROLLINS RD
Mailing Address - Street 2:
Mailing Address - City:ROUND LAKE BEACH
Mailing Address - State:IL
Mailing Address - Zip Code:60073-1334
Mailing Address - Country:US
Mailing Address - Phone:224-814-4466
Mailing Address - Fax:224-814-4291
Practice Address - Street 1:418 E ROLLINS RD
Practice Address - Street 2:
Practice Address - City:ROUND LAKE BEACH
Practice Address - State:IL
Practice Address - Zip Code:60073-1334
Practice Address - Country:US
Practice Address - Phone:224-814-4466
Practice Address - Fax:224-814-4291
Is Sole Proprietor?:No
Enumeration Date:2017-08-23
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL019031366122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist