# PEDIATRIC DENTAL ASSOCIATES OF HOOVER, LLC

> Is this information incorrect? This page shows public data from NPPES. Update your record in NPPES and this page will update automatically within 7 days. [Update your NPPES record](https://nppes.cms.hhs.gov)

- **Entity:** Organization
- **Status:** Active
- **Other names:** PDA of Hoover, LLC
- **Organization subpart:** No

## Provider details

- **NPI number:** 1043954647
- **Authorized official:** BENJAMIN EARL SAMUELSON DMD, MS (ORTHODONTIST/OWNER)
- **Authorized official phone:** (205) 910-0143

## Contact information

- **Practice address:** 5336 STADIUM TRACE PKWY STE 112, HOOVER, AL 35244-4581
- **Practice address phone:** (205) 988-9678
- **Mailing address:** 5336 STADIUM TRACE PKWY STE 112, HOOVER, AL 35244-4581

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 1223P0221X | Pediatric Dentistry | — | NULL | Yes |
| 1223P0221X | Pediatric Dentistry | — | — | Yes |

## Other

- **Enumeration date:** 04/21/2022
- **Last updated:** 04/21/2022