| Professional Dental Alliance Of Kettering, Llc | |
|
4055 Far Hills Ave Kettering OH 45429-2440 | |
| (937) 299-3691 | |
| Not Available |
| Full Name | Professional Dental Alliance Of Kettering, Llc |
|---|---|
| Speciality | Dentist - Oral And Maxillofacial Surgery |
| Location | 4055 Far Hills Ave, Kettering, Ohio |
| Authorized Official Name and Position | Lauren Howard (CREDENTIALING SPECIALIST) |
| Authorized Official Contact | 7575765479 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Professional Dental Alliance Of Kettering, Llc 11 S Mill St Ste 200 New Castle PA 16101-3680 Ph: (757) 576-5479 | Professional Dental Alliance Of Kettering, Llc 4055 Far Hills Ave Kettering OH 45429-2440 Ph: (937) 299-3691 |
| NPI Number | 1558915322 |
|---|---|
| Provider Enumeration Date | 07/30/2019 |
| Last Update Date | 07/30/2019 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1558915322 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223S0112X | Dentist - Oral And Maxillofacial Surgery | (* (Not Available)) | Primary |
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