Organization
PROFESSIONAL DENTAL ALLIANCE OF WEST KENDALL ORTHO, PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
LAUREN HOWARD (CREDENTIALING SPECIALIST)
(757) 576-5479
Entity
Organization
Contact information
Practice address
16371 SW 88TH ST, MIAMI, FL 33196-4942
(305) 459-3192
Mailing address
11 S MILL ST STE 200, NEW CASTLE, PA 16101-3680
Taxonomy
Speciality
Code
Description
License number
State
1223X0400X
Orthodontics and Dentofacial Orthopedics Dentistry
Primary
—
—
Other
Enumeration date
08/26/2019
Last updated
08/26/2019
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