Mallard Dental Inc

LBN: Mallard Dental Inc
Mallard Dental Inc is an health care organization with primary practice located at 33 S Addison Rd Ste 101, Addison IL 60101-3868. The organization recently has only one registered license in Dental Providers / Pediatric Dentistry, which is considered as the primary health care specialty. Mallard Dental Inc can be contacted via phone (630) 834-4343, or through Aralles, Konstadina Anastasia via phone (630) 834-4343.

Contact Information

Primary practice address
33 S Addison Rd Ste 101 Addison IL 60101-3868
Phone: (630) 834-4343
Fax: (630) 834-6308
Website:
Map and Directions
Authorized official contact:
Name: Aralles, Konstadina Anastasia Doctor of Dental Surgery (DDS)
Phone: (630) 834-4343

Health care specialties

SpecialtyCodeLicense #State
Dental Providers / Pediatric Dentistry 1223P0221X Illinois

Profile Details

NPI number 1467437756
LBN Legal business name Mallard Dental Inc
DBA Doing business as
Authorized official Aralles, Konstadina Anastasia Doctor of Dental Surgery (DDS)
Entity Organization
Organization subpart 1 No
Enumeration date Dec 9th, 2005
Last updated Aug 22nd, 2020 - about 6 years ago

1 Some organizations, which are providing health care services, may consist of units or departments that provide different types of health care services or have several separate physical locations, where health care service is provided. These units, departments or physical locations are not themselves legal entities. However, each of them is part of the organization, which is a legal entity. The organization may decide whether its subparts, if it has any, should have their own NPI numbers. In case a subpart conducts any HIPAA standard transactions by itself, without its parent's involvement, it must have its own NPI number.

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Identifiers

StateTypeNumberIssuer
All States NPI 1467437756 NPPES
Illinois MEDICAID 103045
Illinois MEDICAID 1001079

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