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Organization
PPD NORTH AVENUE LLC
Active
Organization
PPD NORTH AVENUE LLC
Active
Other names
Park Place Dental
Organization subpart
No
Provider details
NPI number
Authorized official
DR. ALAN J ACIERNO D.D.S. (OWNER)
(630) 339-3172
Entity
Organization
Contact information
Practice address
7702 W NORTH AVE, ELMWOOD PARK, IL 60707-4123
(630) 339-3172
(847) 891-6775
Mailing address
129 S ROSELLE RD, SUITE 102, SCHAUMBURG, IL 60193-5540
(630) 339-3172
(847) 891-6775
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
—
IL
Other
Enumeration date
07/01/2013
Last updated
07/01/2013
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