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Organization
PROFESSIONAL DENTAL ALLIANCE OF CT - PEDO, PLLC
Active
Organization
PROFESSIONAL DENTAL ALLIANCE OF CT - PEDO, PLLC
Active
Other names
Kids First Pediatric Dentistry & Orthodontics
Organization subpart
No
Provider details
NPI number
Authorized official
ERICA QUINTEROS (CREDENTIALING)
(724) 901-1964
Entity
Organization
Contact information
Practice address
1478 POST RD, FAIRFIELD, CT 06824-5938
(203) 307-1550
(203) 255-7782
Mailing address
125 ENTERPRISE DR STE 200, PITTSBURGH, PA 15275-1223
(724) 901-1964
Taxonomy
Speciality
Code
Description
License number
State
1223P0221X
Pediatric Dentistry
—
NULL
1223P0221X
Pediatric Dentistry
—
—
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
Primary
—
NULL
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
Primary
—
—
Other
Enumeration date
09/21/2023
Last updated
04/02/2024
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