| Luminous Smiles Ltd | |
|
1332 N Rand Rd Palatine IL 60074-2918 | |
| (847) 358-1388 | |
| Not Available |
| Full Name | Luminous Smiles Ltd |
|---|---|
| Speciality | Dentist |
| Location | 1332 N Rand Rd, Palatine, Illinois |
| Authorized Official Name and Position | Sandhya Grace Pallam (PRESIDENT) |
| Authorized Official Contact | 2248050502 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Luminous Smiles Ltd 1332 N Rand Rd Palatine IL 60074-2918 Ph: (847) 358-1388 | Luminous Smiles Ltd 1332 N Rand Rd Palatine IL 60074-2918 Ph: (847) 358-1388 |
| NPI Number | 1851783153 |
|---|---|
| Provider Enumeration Date | 02/23/2015 |
| Last Update Date | 05/21/2015 |
| Medicare PECOS PAC ID | 1153681499 |
|---|---|
| Medicare Enrollment ID | O20180207000945 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1851783153 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 122300000X | Dentist | 019027444 (Illinois) | Primary |
| Provider Name | Sandhya Grace Pallam |
|---|---|
| Provider Type | Practitioner - Dentist |
| Provider Identifiers | NPI Number: 1427256726 PECOS PAC ID: 3971863218 Enrollment ID: I20180207001209 |
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