Provider Demographics
NPI:1972397420
Name:KRIZIA V PALLARCA DMD, P.C
Entity type:Organization
Organization Name:KRIZIA V PALLARCA DMD, P.C
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:KRIZIA VENICE
Authorized Official - Middle Name:
Authorized Official - Last Name:PALLARCA
Authorized Official - Suffix:
Authorized Official - Credentials:DMD
Authorized Official - Phone:224-628-6687
Mailing Address - Street 1:8506 N OZARK AVE
Mailing Address - Street 2:
Mailing Address - City:NILES
Mailing Address - State:IL
Mailing Address - Zip Code:60714-1942
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:4355 HOWARD ST
Practice Address - Street 2:
Practice Address - City:SKOKIE
Practice Address - State:IL
Practice Address - Zip Code:60076-3755
Practice Address - Country:US
Practice Address - Phone:847-796-8731
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-04-08
Last Update Date:2025-05-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Single Specialty