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Organization
PROFESSIONAL DENTAL ALLIANCE OF FLORIDA, PLLC
Active
Organization
PROFESSIONAL DENTAL ALLIANCE OF FLORIDA, PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ERICA QUINTEROS (CREDENTIALING)
(724) 901-1964
Entity
Organization
Contact information
Practice address
499 NW PRIMA VISTA BLVD UNIT 107, PORT ST LUCIE, FL 34983-8786
(772) 336-1500
Mailing address
125 ENTERPRISE DR STE 200, PITTSBURGH, PA 15275-1223
(724) 901-1964
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
—
—
Other
Enumeration date
08/21/2019
Last updated
08/07/2023
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