Healthcare Provider Details

I. General information

NPI: 1497581375
Provider Name (Legal Business Name): PALLAK ARORA BDS, MDS,
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/09/2024
Last Update Date: 09/11/2026
Certification Date: 09/11/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1 COLLEGE ST
PORTLAND ME
04103-2617
US

IV. Provider business mailing address

29555 USONIA DR
SPRING TX
77386-4326
US

V. Phone/Fax

Practice location:
  • Phone: 917-887-5493
  • Fax:
Mailing address:
  • Phone: 917-887-5493
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223X0008X
TaxonomyOral and Maxillofacial Radiology Dentistry
License NumberFDN25
License Number StateME

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: