# PROFESSIONAL DENTAL ALLIANCE

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- **Entity:** Organization
- **Status:** Active
- **Parent organization:** PROFESSIONAL DENTAL ALLIANCE
- **Organization subpart:** Yes

## Provider details

- **NPI number:** 1144525858
- **Legal business name:** PROFESSIONAL DENTAL ALLIANCE
- **Authorized official:** ANDREW S MATTA DMD (MEMBER)
- **Authorized official phone:** (330) 533-3400

## Contact information

- **Practice address:** 2623 WILMINGTON RD, SUITE A, NEW CASTLE, PA 16105-1529
- **Practice address phone:** (724) 658-0822
- **Practice address fax:** (330) 533-2700
- **Mailing address:** 3800 BOARDMAN CANFIELD RD, CANFIELD, OH 44406-9029
- **Mailing address phone:** (330) 533-3400
- **Mailing address fax:** (330) 533-2700

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 1223G0001X | General Practice Dentistry | DP000590 | PA | Yes |

## Other

- **Enumeration date:** 01/12/2011
- **Last updated:** 01/12/2011