Professional Dental Alliance

NPI #1316242001 in Poland, Ohio

Provider Information

NPI Number: 1316242001
Entity Type: Organization
Organization Name: Professional Dental Alliance
Subpart: Yes (part of a larger organization)
Parent Organization: PROFESSIONAL DENTAL ALLIANCE
Primary Specialty: Dentist - General Practice
Enumeration Date: Jan 11, 2011
Last Updated: Jan 11, 2011

Practice Location

Address: 8274 YOUNGSTOWN PITTSBURGH RD
City: Poland
State: Ohio
ZIP Code: 44514-2809
Phone: (330) 757-0880

Authorized Official

Name: ANDREW S MATTA, DMD
Title: MEMBER
Phone: (330) 533-3400

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Dentist - General Practice — General Practice	1223G0001X	Primary

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