Organization
LUMINOUS SMILES LTD
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. SANDHYA GRACE PALLAM DDS (PRESIDENT)
(224) 805-0502
Entity
Organization
Contact information
Practice address
1332 N RAND RD, PALATINE, IL 60074-2918
(847) 358-1388
Mailing address
1332 N RAND RD, PALATINE, IL 60074-2918
(847) 358-1388
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
019027444
IL
Other
Enumeration date
02/23/2015
Last updated
05/21/2015
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