Organization
PDA ORTHODONTICS, LLC
Active
Other names
Medplex Pediatric Dentistry, Samuelson Orthodontics
Organization subpart
No
Provider details
NPI number
Authorized official
DR. BENJAMIN EARL SAMUELSON DMD, MS (ORTHODONTIST/PARTNER)
(205) 910-0143
Entity
Organization
Contact information
Practice address
5564 GROVE BLVD STE A, HOOVER, AL 35226-4601
(205) 988-9678
(205) 988-9065
Mailing address
5564 GROVE BLVD STE A, HOOVER, AL 35226-4601
(205) 988-9678
(205) 988-9065
Taxonomy
Speciality
Code
Description
License number
State
1223X0400X
Orthodontics and Dentofacial Orthopedics Dentistry
Primary
—
—
Other
Enumeration date
08/05/2019
Last updated
09/12/2023
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