| Professional Dental Alliance Of Shadyside, Llc | |
|
3775 Central Ave Shadyside OH 43947-1344 | |
| (740) 676-2604 | |
| Not Available |
| Full Name | Professional Dental Alliance Of Shadyside, Llc |
|---|---|
| Speciality | Dentist |
| Location | 3775 Central Ave, Shadyside, Ohio |
| Authorized Official Name and Position | Lauren Howard (CREDENTIALING SPECIALIST) |
| Authorized Official Contact | 7246982029 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Professional Dental Alliance Of Shadyside, Llc 11 S Mill St Ste 200 New Castle PA 16101-3680 Ph: () - | Professional Dental Alliance Of Shadyside, Llc 3775 Central Ave Shadyside OH 43947-1344 Ph: (740) 676-2604 |
| NPI Number | 1124589585 |
|---|---|
| Provider Enumeration Date | 03/28/2019 |
| Last Update Date | 03/28/2019 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1124589585 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 122300000X | Dentist | (* (Not Available)) | Primary |
Complete Dental Care Of Shadyside Dental Clinic Medicare: Not Enrolled in Medicare Practice Location: 3775 Central Ave, Shadyside, OH 43947 Phone: 740-676-2604 Fax: 740-676-2604 |