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Organization
PROFESSIONAL DENTAL ALLIANCE OF MI - LMTD, PLLC
Active
Organization
PROFESSIONAL DENTAL ALLIANCE OF MI - LMTD, PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ERICA QUINTEROS (CREDENTIALING)
(724) 901-1964
Entity
Organization
Contact information
Practice address
27891 23 MILE RD., CHESTERFIELD, MI 48051
(856) 840-8050
(586) 690-4470
Mailing address
125 ENTERPRISE DR STE 200, PITTSBURGH, PA 15275-1223
(726) 901-1964
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
—
—
Other
Enumeration date
12/15/2022
Last updated
08/09/2023
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