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Organization
PA DENTAL INCORPORATED
Active
Organization
PA DENTAL INCORPORATED
Active
Other names
Blissful Dentistry
Organization subpart
No
Provider details
NPI number
Authorized official
AJITHA PARUCHURI (OWNER)
(847) 730-3771
Entity
Organization
Contact information
Practice address
630 MILWAUKEE AVE STE 130, GLENVIEW, IL 60025-5655
(847) 730-3771
(847) 730-3283
Mailing address
PO BOX 189, NORTHBROOK, IL 60065-0189
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
—
—
Other
Enumeration date
01/03/2020
Last updated
01/03/2020
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