PROFESSIONAL DENTAL ALLIANCE OF ST. AUGUSTINE PLLC NPI 1386294072

NPI Information

PROFESSIONAL DENTAL ALLIANCE OF ST. AUGUSTINE, PLLC is a general practice dentist in St Augustine, FL. The provider is a general dentist is the primary dental care provider for patients of all ages. The general dentist is responsible for the diagnosis, treatment, management and overall coordination of services related to patients' oral health needs. PROFESSIONAL DENTAL ALLIANCE OF ST. AUGUSTINE, PLLC NPI is 1386294072. The provider is registered as an organization entity type and is a multi-specialty group.

The provider's business location address is:

2225 A1A S STE A3
ST AUGUSTINE, FL
ZIP 32080-374
Phone: (904) 201-3442

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 9/16/2019 and was last updated on 9/16/2019.

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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