Provider Demographics
NPI:1679631212
Name:MCALLISTER, DENISE LYNN (DDS)
Entity Type:Individual
Prefix:DR
First Name:DENISE
Middle Name:LYNN
Last Name:MCALLISTER
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:888 BUSSE HWY
Mailing Address - Street 2:
Mailing Address - City:PARK RIDGE
Mailing Address - State:IL
Mailing Address - Zip Code:60068-5901
Mailing Address - Country:US
Mailing Address - Phone:847-518-9025
Mailing Address - Fax:847-518-9027
Practice Address - Street 1:888 BUSSE HWY
Practice Address - Street 2:
Practice Address - City:PARK RIDGE
Practice Address - State:IL
Practice Address - Zip Code:60068-5901
Practice Address - Country:US
Practice Address - Phone:847-518-9025
Practice Address - Fax:847-518-9027
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-05
Last Update Date:2020-11-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL021-0019021223P0221X
IL0190242441223P0221X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223P0221XDental ProvidersDentistPediatric Dentistry