Professional Dental Alliance of Suntree, Pllc

NPI #1669951356 in Melbourne, Florida

Provider Information

NPI Number: 1669951356
Entity Type: Organization
Organization Name: Professional Dental Alliance of Suntree, Pllc
Primary Specialty: Dentist - General Practice
Enumeration Date: Aug 13, 2018
Last Updated: Aug 13, 2018

Practice Location

Address: 7827 N WICKHAM RD
City: Melbourne
State: Florida
ZIP Code: 32940-8289
Phone: (321) 434-4444

Authorized Official

Name: ANNETTE MARLOW
Title: CREDENTIALING SUPERVISOR
Phone: (724) 698-2119

Specialties & Taxonomy Codes

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

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