Professional Dental Alliance

NPI #1457656621 in Boardman, Ohio

Provider Information

NPI Number
1457656621
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 20, 2011
Last Updated
Jan 20, 2011

Practice Location

Address
6540 SOUTH AVE
State
Ohio
ZIP Code
44512-3651
Phone
(330) 758-6165

Authorized Official

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

Specialties & Taxonomy Codes

Specialty
Dentist - General PracticeGeneral Practice

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