Organization
PROFESSIONAL DENTAL ALLIANCE
Active
Other names
Professional Dental Alliance
Organization subpart
No
Provider details
NPI number
Authorized official
DR. ANDREW MATTA D.D.S. (CHIEF MEDICAL OFFICER)
(724) 674-2965
Entity
Organization
Contact information
Practice address
11201 SHAKER BLVD, 136, CLEVELAND, OH 44104-3869
(216) 368-7238
Mailing address
11 S MILL ST, NEW CASTLE, PA 16101-3613
(724) 698-2500
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
30-023665
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
30023665
LICENSE NUMBER
OH
Enumeration date
03/25/2015
Last updated
03/25/2015
Update your record
If you believe information in your NPPES record is inaccurate, or if you wish to update or deactivate your NPI, you can do so directly with CMS at https://nppes.cms.hhs.gov.
About Stedi
Stedi is the only programmable healthcare clearinghouse. You can use Stedi's APIs to process eligibility checks, claims, remits, and more.
Sign up