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General NPI Number Information
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NPI Number | 1487911624
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Entity Type | Organization
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Legal Business Name | PALDENTAL GROUP, PC
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Dates
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Enumeration Date | 04/12/2012
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Last Update Date | 04/12/2012
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Provider Practice Location Address
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Address Line | 1890 SILVER CROSS BLVD SUITE 470
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City | NEW LENOX
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State | IL
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Zip | 60451-9508
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Country | US
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Telephone | 815-717-8793
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Fax | 815-717-8796
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Provider Business Mailing Address
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Address Line | 1890 SILVER CROSS BLVD SUITE 470
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City | NEW LENOX
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State | IL
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Zip | 60451-9508
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Country | US
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Telephone | 815-717-8793
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Fax | 815-717-8796
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. AROON PAL
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Credential | DMD
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Telephone | 815-717-8793
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 122300000X
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Taxonomy Name | Dentist
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License Number | 019022659
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License Number State | IL
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