Organization
PROFESSONAL DENTAL ALLIANCE OF WORTHINGTON, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ERICA QUINTEROS (CREDENTIALING ENROLLMENT MANAGER)
(724) 901-1964
Entity
Organization
Contact information
Practice address
150 E WILSON BRIDGE RD STE 150, WORTHINGTON, OH 43085-2394
(614) 888-0377
Mailing address
125 ENTERPRISE DR STE 200, PITTSBURGH, PA 15275-1223
(724) 698-2500
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
—
—
Other
Enumeration date
01/11/2019
Last updated
01/30/2024
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