Organization
PROFESSIONAL DENTAL ALLIANCE OF KETTERING, LLC
Active
Other names
Far Hills Dentistry
Organization subpart
No
Provider details
NPI number
Authorized official
LAUREN HOWARD MA (CREDENTIALING SPECIALIST)
(724) 698-2029
Entity
Organization
Contact information
Practice address
4055 FAR HILLS AVE, KETTERING, OH 45429-2440
(877) 959-5405
Mailing address
11 S MILL ST STE 200, NEW CASTLE, PA 16101-3680
(724) 698-2500
(844) 399-0385
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
—
—
Other
Enumeration date
12/18/2018
Last updated
12/18/2018
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