# PROFESSIONAL DENTAL ALLIANCE OF MI - LMTD, PLLC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1447962055
- **Authorized official:** ERICA QUINTEROS (CREDENTIALING)
- **Authorized official phone:** (724) 901-1964

## Contact information

- **Practice address:** 27891 23 MILE RD., CHESTERFIELD, MI 48051
- **Practice address phone:** (856) 840-8050
- **Practice address fax:** (586) 690-4470
- **Mailing address:** 125 ENTERPRISE DR STE 200, PITTSBURGH, PA 15275-1223
- **Mailing address phone:** (726) 901-1964

## Taxonomy

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

## Other

- **Enumeration date:** 12/15/2022
- **Last updated:** 08/09/2023