Individual
CYRIL PANDARAKALAM
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
2800 COLLEGE AVE BLDG 288, ALTON, IL 62002-4742
(618) 474-7285
Mailing address
2800 COLLEGE AVE BLDG 288, ALTON, IL 62002-4742
(618) 474-7285
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
019.028578
IL
122300000X
Dentist
DE60130362
WA
Other
Enumeration date
02/23/2012
Last updated
02/11/2022
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