| Pali, Llc | |
|
5511 W Glendale Ave Glendale AZ 85301-2522 | |
| (623) 937-9241 | |
| Not Available |
| Full Name | Pali, Llc |
|---|---|
| Speciality | Dentist - General Practice |
| Location | 5511 W Glendale Ave, Glendale, Arizona |
| Authorized Official Name and Position | Charisma Luat (DENTIST/OWNER) |
| Authorized Official Contact | 6239379241 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Pali, Llc 5511 W Glendale Ave Glendale AZ 85301-2522 Ph: (623) 937-9241 | Pali, Llc 5511 W Glendale Ave Glendale AZ 85301-2522 Ph: (623) 937-9241 |
| NPI Number | 1710438676 |
|---|---|
| Provider Enumeration Date | 10/17/2016 |
| Last Update Date | 03/15/2024 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1710438676 | NPI | - | NPPES |
| 120792 | Medicaid | AZ |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223G0001X | Dentist - General Practice | D008569 (Arizona) | Primary |
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