| Professional Dental Alliance Of Warren, Llc | |
|
5078 Mahoning Ave Nw Warren OH 44483-1408 | |
| (330) 847-7373 | |
| Not Available |
| Full Name | Professional Dental Alliance Of Warren, Llc |
|---|---|
| Speciality | Dentist |
| Location | 5078 Mahoning Ave Nw, Warren, 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 Warren, Llc 11 S Mill St Ste 200 New Castle PA 16101-3680 Ph: () - | Professional Dental Alliance Of Warren, Llc 5078 Mahoning Ave Nw Warren OH 44483-1408 Ph: (330) 847-7373 |
| NPI Number | 1922561919 |
|---|---|
| Provider Enumeration Date | 04/08/2019 |
| Last Update Date | 04/08/2019 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1922561919 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 122300000X | Dentist | (* (Not Available)) | Primary |
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