| Professional Dental Alliance Specialty, LLC | |
|
6540 South Ave Boardman OH 44512-3651 | |
| (330) 721-0606 | |
| Not Available |
| Full Name | Professional Dental Alliance Specialty, LLC |
|---|---|
| Speciality | Dentist |
| Location | 6540 South Ave, Boardman, Ohio |
| Authorized Official Name and Position | Erica Quinteros (CREDENTIALING) |
| Authorized Official Contact | 7249011964 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Professional Dental Alliance Specialty, LLC 125 Enterprise Dr Ste 200 Pittsburgh PA 15275-1223 Ph: (724) 698-2500 | Professional Dental Alliance Specialty, LLC 6540 South Ave Boardman OH 44512-3651 Ph: (330) 721-0606 |
| NPI Number | 1861788945 |
|---|---|
| Provider Enumeration Date | 06/27/2011 |
| Last Update Date | 03/25/2024 |
| Certification Date | 03/25/2024 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1861788945 | NPI | - | NPPES |
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