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Organization

PEDIATRIC DENTAL ASSOCIATES OF HOOVER, LLC

Active
Other names
PDA of Hoover, LLC
Organization subpart
No

Provider details

NPI number
Authorized official
BENJAMIN EARL SAMUELSON DMD, MS (ORTHODONTIST/OWNER)
(205) 910-0143
Entity
Organization

Contact information

Practice address
5336 STADIUM TRACE PKWY STE 112, HOOVER, AL 35244-4581
(205) 988-9678
Mailing address
5336 STADIUM TRACE PKWY STE 112, HOOVER, AL 35244-4581

Taxonomy

Speciality
Code
Description
License number
State
1223P0221X
Pediatric Dentistry
Primary

Other

Enumeration date
04/21/2022
Last updated
04/21/2022
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