# PROFESSIONAL DENTAL ALLIANCE, LLC

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Grove City Dental
- **Organization subpart:** No

## Provider details

- **NPI number:** 1689034365
- **Authorized official:** DR. CHAD WISE DDS (DENTIST/OWNER)
- **Authorized official phone:** (614) 808-1000

## Contact information

- **Practice address:** 11 S MILL ST, 200, NEW CASTLE, PA 16101-3613
- **Practice address phone:** (724) 698-2500
- **Mailing address:** 4079 GANTZ RD, GROVE CITY, OH 43123-4912
- **Mailing address phone:** (614) 808-1000
- **Mailing address fax:** (614) 801-0003

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 122300000X | Dentist | 30.022975 | OH | Yes |

## Other

- **Enumeration date:** 02/24/2016
- **Last updated:** 02/24/2016