| Professional Dental Alliance Of Florida, Pllc | |
|
499 Nw Prima Vista Blvd Unit 107 Port St Lucie FL 34983-8786 | |
| (772) 336-1500 | |
| Not Available |
| Full Name | Professional Dental Alliance Of Florida, Pllc |
|---|---|
| Speciality | Dentist - General Practice |
| Location | 499 Nw Prima Vista Blvd Unit 107, Port St Lucie, Florida |
| Authorized Official Name and Position | Erica Quinteros (CREDENTIALING) |
| Authorized Official Contact | 7249011964 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Professional Dental Alliance Of Florida, Pllc 125 Enterprise Dr Ste 200 Pittsburgh PA 15275-1223 Ph: (724) 901-1964 | Professional Dental Alliance Of Florida, Pllc 499 Nw Prima Vista Blvd Unit 107 Port St Lucie FL 34983-8786 Ph: (772) 336-1500 |
| NPI Number | 1750938072 |
|---|---|
| Provider Enumeration Date | 08/21/2019 |
| Last Update Date | 08/07/2023 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1750938072 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223G0001X | Dentist - General Practice | (* (Not Available)) | Primary |
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