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Organization
PROFESSIONAL DENTAL ALLIANCE OF PALM BAY PALM BAY RD, PLLC
Active
Organization
PROFESSIONAL DENTAL ALLIANCE OF PALM BAY PALM BAY RD, PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
LAUREN HOWARD (CREDENTIALING SPECIALIST)
(757) 576-5479
Entity
Organization
Contact information
Practice address
1890 PALM BAY RD NE STE 2, PALM BAY, FL 32905-3071
(321) 724-5100
Mailing address
11 S MILL ST STE 200, NEW CASTLE, PA 16101-3680
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
—
—
Other
Enumeration date
09/17/2019
Last updated
09/17/2019
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