# PROFESSIONAL DENTAL ALLIANCE OF CT - PEDO, PLLC

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Kids First Pediatric Dentistry & Orthodontics
- **Organization subpart:** No

## Provider details

- **NPI number:** 1942088786
- **Authorized official:** ERICA QUINTEROS (CREDENTIALING)
- **Authorized official phone:** (724) 901-1964

## Contact information

- **Practice address:** 1478 POST RD, FAIRFIELD, CT 06824-5938
- **Practice address phone:** (203) 307-1550
- **Practice address fax:** (203) 255-7782
- **Mailing address:** 125 ENTERPRISE DR STE 200, PITTSBURGH, PA 15275-1223
- **Mailing address phone:** (724) 901-1964

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 1223P0221X | Pediatric Dentistry | — | NULL | — |
| 1223P0221X | Pediatric Dentistry | — | — | — |
| 1223S0112X | Oral and Maxillofacial Surgery (Dentist) | — | NULL | Yes |
| 1223S0112X | Oral and Maxillofacial Surgery (Dentist) | — | — | Yes |

## Other

- **Enumeration date:** 09/21/2023
- **Last updated:** 04/02/2024