PROFESSIONAL DENTAL ALLIANCE OF CENTERVILLE LLC NPI 1124672092

NPI Information

PROFESSIONAL DENTAL ALLIANCE OF CENTERVILLE, LLC is an oral and maxillofacial surgery dentist in Centerville, OH. The provider is an oral and maxillofacial surgery dentist specialized in the diagnosis, surgical and adjunctive treatment of diseases, injuries and defects involving both the functional and esthetic aspects of the hard and soft tissues of the oral and maxillofacial region. PROFESSIONAL DENTAL ALLIANCE OF CENTERVILLE, LLC NPI is 1124672092. The provider is registered as an organization entity type and is a multi-specialty group.

The provider's business location address is:

9420 DAYTON LEBANON PIKE
CENTERVILLE, OH
ZIP 45458-860
Phone: (937) 433-8900

The provider's authorized official is Lauren Howard .
The authorized official title is Credentialing Specialist and has the following contact phone number (757) 576-5479.

The enumeration date for this NPI number is 7/30/2019 and was last updated on 7/30/2019.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

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