Provider Demographics
NPI:1760739403
Name:PACHINA, ALLISON MARIE (RDH)
Entity Type:Individual
Prefix:MS
First Name:ALLISON
Middle Name:MARIE
Last Name:PACHINA
Suffix:
Gender:F
Credentials:RDH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1095 COVINGTON DR
Mailing Address - Street 2:
Mailing Address - City:LEMONT
Mailing Address - State:IL
Mailing Address - Zip Code:60439-8565
Mailing Address - Country:US
Mailing Address - Phone:630-901-0163
Mailing Address - Fax:
Practice Address - Street 1:1095 COVINGTON DR
Practice Address - Street 2:
Practice Address - City:LEMONT
Practice Address - State:IL
Practice Address - Zip Code:60439-8565
Practice Address - Country:US
Practice Address - Phone:630-901-0163
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-08-13
Last Update Date:2012-08-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL020014142124Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes124Q00000XDental ProvidersDental Hygienist