Organization
PROFESSIONAL DENTAL ALLIANCE OF MA - ORTHO, PLLC
Active
Other names
Southeast Orthodontics
Organization subpart
No
Provider details
NPI number
Authorized official
ERICA QUINTEROS (CREDENTIALING)
(724) 901-1964
Entity
Organization
Contact information
Practice address
408 STATE RD STE 730, DARTMOUTH, MA 02747-4302
(508) 990-3000
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
08/18/2023
Last updated
08/18/2023
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