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PROFESSIONAL DENTAL ALLIANCE OF PALM BAY PLLC NPI 1770062465


NPI Information

NPI: 1770062465
Provider Name: PROFESSIONAL DENTAL ALLIANCE OF PALM BAY, PLLC

Doing Business As: PALM BAY DENTAL CENTER

Classification: Dentist - 1223G0001X
Entity Type: Organization

Specialization: General Practice

Address:
1764 PALM BAY RD NE
PALM BAY, FL
ZIP 32905
Phone: (321) 725-5512
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PROFESSIONAL DENTAL ALLIANCE OF PALM BAY, PLLC is a general practice dentist in Palm Bay, 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 PALM BAY, PLLC NPI is 1770062465. The provider is registered as an organization entity type and is a multi-specialty group.
The provider Is Doing Business As Palm Bay Dental Center.

The provider's business location address is:

1764 PALM BAY RD NE
PALM BAY, FL
ZIP 32905-904
Phone: (321) 725-5512

The provider's authorized official is Annette Marlow .
The authorized official title is Credentialing Supervisor and has the following contact phone number (321) 725-5512.

The enumeration date for this NPI number is 8/13/2018 and was last updated on 8/13/2018.


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:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
11223G0001XDentistGeneral PracticeYes

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 5/5/2024

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