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Organization
PROFESSIONAL DENTAL ALLIANCE OF CLEARWATER, PLLC
Active
Organization
PROFESSIONAL DENTAL ALLIANCE OF CLEARWATER, PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
LAUREN HOWARD MA (CREDENTIALING SPECIALIST)
(724) 698-2029
Entity
Organization
Contact information
Practice address
2685 ULMERTON RD STE 103, CLEARWATER, FL 33762-3332
(727) 572-4063
Mailing address
11 S MILL ST STE 200, NEW CASTLE, PA 16101-3680
(724) 698-2500
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
—
—
Other
Enumeration date
01/09/2019
Last updated
01/09/2019
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