Organization
PROFESSIONAL DENTAL ALLIANCE, LLC
Active
Other names
Grove City Dental
Organization subpart
No
Provider details
NPI number
Authorized official
DR. CHAD WISE DDS (DENTIST/OWNER)
(614) 808-1000
Entity
Organization
Contact information
Practice address
11 S MILL ST, 200, NEW CASTLE, PA 16101-3613
(724) 698-2500
Mailing address
4079 GANTZ RD, GROVE CITY, OH 43123-4912
(614) 808-1000
(614) 801-0003
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
30.022975
OH
Other
Enumeration date
02/24/2016
Last updated
02/24/2016
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