| Professional Dental Alliance Of Centerville, Llc | |
|
9420 Dayton Lebanon Pike Centerville OH 45458-3860 | |
| (937) 433-8900 | |
| Not Available |
| Full Name | Professional Dental Alliance Of Centerville, Llc |
|---|---|
| Speciality | Dentist - Oral And Maxillofacial Surgery |
| Location | 9420 Dayton Lebanon Pike, Centerville, Ohio |
| Authorized Official Name and Position | Lauren Howard (CREDENTIALING SPECIALIST) |
| Authorized Official Contact | 7575765479 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Professional Dental Alliance Of Centerville, Llc 11 S Mill St Ste 200 New Castle PA 16101-3680 Ph: (757) 576-5479 | Professional Dental Alliance Of Centerville, Llc 9420 Dayton Lebanon Pike Centerville OH 45458-3860 Ph: (937) 433-8900 |
| NPI Number | 1124672092 |
|---|---|
| Provider Enumeration Date | 07/30/2019 |
| Last Update Date | 07/30/2019 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1124672092 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223S0112X | Dentist - Oral And Maxillofacial Surgery | (* (Not Available)) | Primary |
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