Professonal Dental Alliance of Worthington, LLC

NPI #1356815401 in Worthington, Ohio

Provider Information

NPI Number: 1356815401
Entity Type: Organization
Organization Name: Professonal Dental Alliance of Worthington, LLC
Primary Specialty: Dentist
Enumeration Date: Jan 11, 2019
Last Updated: Jan 30, 2024

Practice Location

Address: 150 E WILSON BRIDGE RD STE 150
City: Worthington
State: Ohio
ZIP Code: 43085-2394
Phone: (614) 888-0377

Authorized Official

Name: ERICA QUINTEROS
Title: CREDENTIALING ENROLLMENT MANAGER
Phone: (724) 901-1964

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Dentist	122300000X	Primary

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