Organization
MALLARD DENTAL INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. KONSTADINA ANASTASIA ARALLES DDS (PRESIDENT)
(630) 834-4343
Entity
Organization
Contact information
Practice address
33 S ADDISON RD, STE 101, ADDISON, IL 60101-3868
(630) 834-4343
(630) 834-6308
Mailing address
33 S ADDISON RD, STE 101, ADDISON, IL 60101-3868
(630) 834-4343
(630) 834-6308
Taxonomy
Speciality
Code
Description
License number
State
1223P0221X
Pediatric Dentistry
Primary
—
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1001079
—
IL
05
—
103045
—
IL
Enumeration date
12/09/2005
Last updated
08/22/2020
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