Organization
ALLIANCE DENTAL PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MICHAEL HENRIOD (MANAGER)
(801) 792-7018
Entity
Organization
Contact information
Practice address
275 14TH ST NW STE 100, ATLANTA, GA 30318-9100
(801) 792-7018
Mailing address
1808 VERDUGO BLVD STE 207, GLENDALE, CA 91208-1414
Taxonomy
Speciality
Code
Description
License number
State
1223X0400X
Orthodontics and Dentofacial Orthopedics Dentistry
Primary
—
—
Other
Enumeration date
06/11/2024
Last updated
06/11/2024
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