| Professional Dental Alliance Of Ct - Ortho, Pllc | |
|
1476 Post Rd Fairfield CT 06824-5937 | |
| (203) 307-0996 | |
| (203) 292-9596 |
| Full Name | Professional Dental Alliance Of Ct - Ortho, Pllc |
|---|---|
| Speciality | Dentist - Orthodontics And Dentofacial Orthopedics |
| Location | 1476 Post Rd, Fairfield, Connecticut |
| 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 Of Ct - Ortho, Pllc 125 Enterprise Dr Ste 200 Pittsburgh PA 15275-1223 Ph: (724) 901-1964 | Professional Dental Alliance Of Ct - Ortho, Pllc 1476 Post Rd Fairfield CT 06824-5937 Ph: (203) 307-0996 |
| NPI Number | 1306624143 |
|---|---|
| Provider Enumeration Date | 09/21/2023 |
| Last Update Date | 09/21/2023 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1306624143 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223X0400X | Dentist - Orthodontics And Dentofacial Orthopedics | (* (Not Available)) | Primary |
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