Professional Dental Alliance of Prt St Lucie St Lucie, Pllc
NPI #1003473257 in Port St Lucie, Florida
Provider Information
- NPI Number
- 1003473257
- Entity Type
- Organization
- Organization Name
- Professional Dental Alliance of Prt St Lucie St Lucie, Pllc
- Primary Specialty
- Dentist - General Practice
- Enumeration Date
- May 23, 2019
- Last Updated
- May 23, 2019
Practice Location
- Address
- 1202 SE PORT ST LUCIE BLVD
- City
- Port St Lucie
- State
- Florida
- ZIP Code
- 34952-5364
- Phone
- (772) 335-3088
Authorized Official
- Name
- JESSICA BARRETTE
- Title
- CREDENTIALING SPECIALIST
- Phone
- (724) 698-2997
Specialties & Taxonomy Codes
| Specialty |
|---|
| Dentist - General Practice — General Practice |
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