Professional Dental Alliance of Colchester, Pllc
NPI #1780175208 in Colchester, Connecticut
Provider Information
- NPI Number
- 1780175208
- Entity Type
- Organization
- Organization Name
- Professional Dental Alliance of Colchester, Pllc
- Primary Specialty
- Dentist - General Practice
- Enumeration Date
- May 21, 2018
- Last Updated
- May 21, 2018
Practice Location
- Address
- 151 BROADWAY ST
- City
- Colchester
- State
- Connecticut
- ZIP Code
- 06415-1056
- Phone
- (860) 537-1444
Authorized Official
- Name
- ANDREW MATTA, DMD
- Title
- CMO/OWNER
- Phone
- (724) 698-2500
Specialties & Taxonomy Codes
| Specialty |
|---|
| Dentist - General Practice — General Practice |
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