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General NPI Number Information
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NPI Number | 1669364360
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Entity Type | Individual
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Provider Name | PREETAM VILAS PABALKAR
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Gender | Female
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Dates
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Enumeration Date | 07/17/2025
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Last Update Date | 07/17/2025
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Provider Practice Location Address
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Address Line | 8030 SPRING VALLEY RD
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City | DALLAS
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State | TX
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Zip | 75240-3827
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Country | US
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Telephone | 972-716-2995
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Fax |
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Provider Business Mailing Address
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Address Line | 6301 STONEWOOD DR APT 1621
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City | PLANO
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State | TX
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Zip | 75024-5274
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Country | US
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Telephone | 424-206-0245
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1223G0001X
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Taxonomy Name | General Practice Dentistry
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License Number | 41781
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License Number State | TX
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