Professional Dental Alliance of Warren, LLC

NPI #1922561919 in Warren, Ohio

Provider Information

NPI Number: 1922561919
Entity Type: Organization
Organization Name: Professional Dental Alliance of Warren, LLC
Primary Specialty: Dentist
Enumeration Date: Apr 8, 2019
Last Updated: Jul 3, 2024

Practice Location

Address: 4329 MAHONING AVE NW STE B
City: Warren
State: Ohio
ZIP Code: 44483-1974
Phone: (330) 847-7373

Authorized Official

Name: AMANDA KURTZ
Title: CREDENTIALING SPECIALIST
Phone: (724) 698-2946

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Dentist	122300000X	Primary

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