Organization
PROFESSIONAL DENTAL ALLIANCE OF CT - ORTHO, PLLC
Active
Other names
First Impressions Orthodontics
Organization subpart
No
Provider details
NPI number
Authorized official
ERICA QUINTEROS (CREDENTIALING)
(724) 901-1964
Entity
Organization
Contact information
Practice address
1476 POST RD, FAIRFIELD, CT 06824-5937
(203) 307-0996
(203) 292-9596
Mailing address
125 ENTERPRISE DR STE 200, PITTSBURGH, PA 15275-1223
(724) 901-1964
Taxonomy
Speciality
Code
Description
License number
State
1223X0400X
Orthodontics and Dentofacial Orthopedics Dentistry
Primary
—
—
Other
Enumeration date
09/21/2023
Last updated
09/21/2023
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