Organization
PARK PLACE DENTAL LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. ZACHARY N SOIYA DDS (OWNER)
(630) 453-7275
Entity
Organization
Contact information
Practice address
7702 W NORTH AVE, ELMWOOD PARK, IL 60707-4123
(708) 453-7275
Mailing address
7702 W NORTH AVE, ELMWOOD PARK, IL 60707-4123
(708) 453-7275
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
1917894
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1821135823
NPI
IL
Enumeration date
07/08/2008
Last updated
07/08/2008
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