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Organization
PEDIATRIC DENTAL ASSOCIATES OF HOOVER, LLC
Active
Organization
PEDIATRIC DENTAL ASSOCIATES OF HOOVER, LLC
Active
Other names
PDA of Hoover, LLC
Organization subpart
No
Provider details
NPI number
Authorized official
BENJAMIN EARL SAMUELSON DMD, MS (ORTHODONTIST/OWNER)
(205) 910-0143
Entity
Organization
Contact information
Practice address
5336 STADIUM TRACE PKWY STE 112, HOOVER, AL 35244-4581
(205) 988-9678
Mailing address
5336 STADIUM TRACE PKWY STE 112, HOOVER, AL 35244-4581
Taxonomy
Speciality
Code
Description
License number
State
1223P0221X
Pediatric Dentistry
Primary
—
NULL
1223P0221X
Pediatric Dentistry
Primary
—
—
Other
Enumeration date
04/21/2022
Last updated
04/21/2022
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