Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Pine Glen Dental Group, Ltd

Organization General Practice Dentistry · NPI 1659589299

Pine Glen Dental Group, Ltd is a General Practice Dentistry in Peoria, Illinois. Licensed in Illinois. Registered with an NPI since 2007.

Licensed in
IL
In the registry since
2007
What do these letters mean?
Ltd — Limited
A form of business registration, not a clinical qualification.

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Practice location Address checks out

838 W Glen Ave
Peoria, IL 61614-4835
Phone: (309) 691-1990
Fax: (309) 691-9112
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

General Practice Dentistry (primary) Taxonomy 1223G0001X (IL)

Record details

NPI number1659589299
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official Robert Pollard — President · (309) 691-1990
NPI enumeratedMay 18, 2007
Last updated in NPPESAugust 22, 2020
Mailing address838 W Glen Ave, Peoria, IL 61614-4835

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