Organization
HERITAGE GROVE FAMILY DENTAL P.C.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. PETE A GALLOS DDS (DENTIST)
(815) 254-1375
Entity
Organization
Contact information
Practice address
12426 S VAN DYKE RD, UNIT B, PLAINFIELD, IL 60585-2700
(815) 254-1375
Mailing address
12426 S VAN DYKE RD, UNIT B, PLAINFIELD, IL 60585-2700
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
019025501
IL
Other
Enumeration date
04/14/2014
Last updated
04/14/2014
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