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Organization

PROFESSIONAL DENTAL ALLIANCE OF GEORGIA, LLC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
ANDREW MATTA (OWNER)
(724) 698-2500
Entity
Organization

Contact information

Practice address
3466 COBB PKWY NW STE 170, ACWORTH, GA 30101-5768
(770) 203-1711
(404) 855-4104
Mailing address
11 S MILL ST, NEW CASTLE, PA 16101-3680

Taxonomy

Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
DN013474
GA

Other

Enumeration date
01/11/2018
Last updated
03/17/2018
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