Pine Glen Dental Group, Ltd

LBN: Pine Glen Dental Group, Ltd
Pine Glen Dental Group, Ltd is an health care organization with primary practice located at 838 W Glen Ave , Peoria IL 61614-4835. The organization recently has only one registered license in Dental Providers / General Practice, which is considered as the primary health care specialty. Pine Glen Dental Group, Ltd can be contacted via phone (309) 691-1990, or through Pollard, Robert Michael via phone (309) 691-1990.

Contact Information

Primary practice address
838 W Glen Ave Peoria IL 61614-4835
Phone: (309) 691-1990
Fax: (309) 691-9112
Website:
Map and Directions
Authorized official contact:
Name: Pollard, Robert Michael Doctor of Dental Surgery (DDS)
Phone: (309) 691-1990

Health care specialties

SpecialtyCodeLicense #State
Dental Providers / General Practice 1223G0001X Illinois

Profile Details

NPI number 1659589299
LBN Legal business name Pine Glen Dental Group, Ltd
DBA Doing business as
Authorized official Pollard, Robert Michael Doctor of Dental Surgery (DDS)
Entity Organization
Organization subpart 1 No
Enumeration date May 18th, 2007
Last updated Aug 22nd, 2020 - about 4 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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