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Organization
PROFESSIONAL DENTAL ALLIANCE OF COLCHESTER, PLLC
Active
Organization
PROFESSIONAL DENTAL ALLIANCE OF COLCHESTER, PLLC
Active
Other names
Life Long Dental Care of Colchester
Organization subpart
No
Provider details
NPI number
Authorized official
ANDREW MATTA DMD (CMO/OWNER)
(724) 698-2500
Entity
Organization
Contact information
Practice address
151 BROADWAY ST, COLCHESTER, CT 06415-1056
(860) 537-1444
Mailing address
11 S MILL ST STE 200, NEW CASTLE, PA 16101-3680
(724) 698-2500
(724) 652-4619
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
—
—
Other
Enumeration date
05/21/2018
Last updated
05/21/2018
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