| Professional Dental Alliance Of Illinois Specialty, Pllc | |
|
4160 Il Route 83 Ste 308 Long Grove IL 60047-8034 | |
| (847) 634-6166 | |
| Not Available |
| Full Name | Professional Dental Alliance Of Illinois Specialty, Pllc |
|---|---|
| Speciality | Dentist - Pediatric Dentistry |
| Location | 4160 Il Route 83 Ste 308, Long Grove, Illinois |
| Authorized Official Name and Position | Erica Quinteros (CREDENTIALING) |
| Authorized Official Contact | 7249011964 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Professional Dental Alliance Of Illinois Specialty, Pllc 125 Enterprise Dr Ste 200 Pittsburgh PA 15275-1223 Ph: (249) 011-9647 | Professional Dental Alliance Of Illinois Specialty, Pllc 4160 Il Route 83 Ste 308 Long Grove IL 60047-8034 Ph: (847) 634-6166 |
| NPI Number | 1558145227 |
|---|---|
| Provider Enumeration Date | 08/23/2023 |
| Last Update Date | 12/13/2023 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1558145227 | NPI | - | NPPES |
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