Professional Dental Alliance, LLC

NPI #1215478706 in Hebron, Ohio

Provider Information

NPI Number: 1215478706
Entity Type: Organization
Organization Name: Professional Dental Alliance, LLC
Primary Specialty: Dentist
Enumeration Date: Mar 16, 2017
Last Updated: Mar 16, 2017

Practice Location

Address: 820 W MAIN ST
City: Hebron
State: Ohio
ZIP Code: 43025-9033
Phone: (740) 928-0761

Authorized Official

Name: ANDREW MATTA, DMD
Title: OWNER
Phone: (724) 698-2119

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Dentist	122300000X	Primary

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