Professional Dental Alliance of St Cloud - Kissimmee, Pllc
NPI #1568941300 in Saint Cloud, Florida
Provider Information
- NPI Number
- 1568941300
- Entity Type
- Organization
- Organization Name
- Professional Dental Alliance of St Cloud - Kissimmee, Pllc
- Primary Specialty
- Dentist - General Practice
- Enumeration Date
- Aug 13, 2018
- Last Updated
- Aug 13, 2018
Practice Location
- Address
- 3101 13TH ST
- City
- Saint Cloud
- State
- Florida
- ZIP Code
- 34769-5925
- Phone
- (407) 957-2000
Authorized Official
- Name
- ANNETTTE MARLOW
- Title
- CREDENTIALING SUPERVISOR
- Phone
- (724) 698-2119
Specialties & Taxonomy Codes
| Specialty |
|---|
| Dentist - General Practice — General Practice |
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