Organization
PROFESSIONAL DENTAL ALLAINCE OF MASSACHUSETTS PLLC
Active
Other names
Innovative Dental
Organization subpart
No
Provider details
NPI number
Authorized official
ANDREW MATTA (OWNER)
(724) 698-2500
Entity
Organization
Contact information
Practice address
17 MAIN ST, BOYLSTON, MA 01505-1948
(508) 869-6388
Mailing address
11 S MILL ST STE 200, NEW CASTLE, PA 16101-3680
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
—
—
Other
Enumeration date
12/19/2019
Last updated
12/19/2019
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