| Professional Dental Alliance Of Indiana, Llc | |
|
11 S Mill St Suite 200 New Castle PA 16101-3613 | |
| (724) 698-2500 | |
| (724) 652-4160 |
| Full Name | Professional Dental Alliance Of Indiana, Llc |
|---|---|
| Speciality | Dentist |
| Location | 11 S Mill St, New Castle, Pennsylvania |
| Authorized Official Name and Position | Andrew Matta (OWNER) |
| Authorized Official Contact | 7246982500 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Professional Dental Alliance Of Indiana, Llc 11 S Mill St Suite 200 New Castle PA 16101-3613 Ph: (724) 698-2500 | Professional Dental Alliance Of Indiana, Llc 11 S Mill St Suite 200 New Castle PA 16101-3613 Ph: (724) 698-2500 |
| NPI Number | 1013372903 |
|---|---|
| Provider Enumeration Date | 12/21/2015 |
| Last Update Date | 12/27/2015 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1013372903 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 122300000X | Dentist | 12012359A (Indiana) | Primary |
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