<Unavail>

LBN: Professional Dental Alliance
<Unavail> is an health care organization with primary practice located at 11201 Shaker Blvd 136, Cleveland OH 44104-3869. The organization recently has only one registered license in Dental Providers / Dentist, which is considered as the primary health care specialty. Professional Dental Alliance can be contacted via phone (216) 368-7238, or through Matta, Andrew via phone (724) 674-2965.

Contact Information

Primary practice address
11201 Shaker Blvd 136 Cleveland OH 44104-3869
Phone: (216) 368-7238
Fax:
Website:
Map and Directions
Authorized official contact:
Name: Matta, Andrew Doctor of Dental Surgery (DDS)
Phone: (724) 674-2965

Health care specialties

SpecialtyCodeLicense #State
Dental Providers / Dentist 122300000X 30-023665 Ohio

Profile Details

NPI number 1790179992
LBN Legal business name Professional Dental Alliance
DBA Doing business as <Unavail>
Authorized official Matta, Andrew Doctor of Dental Surgery (DDS)
Entity Organization
Organization subpart 1 No
Enumeration date Mar 25th, 2015
Last updated Mar 25th, 2015 - about 11 years ago

1 Some organizations, which are providing health care services, may consist of units or departments that provide different types of health care services or have several separate physical locations, where health care service is provided. These units, departments or physical locations are not themselves legal entities. However, each of them is part of the organization, which is a legal entity. The organization may decide whether its subparts, if it has any, should have their own NPI numbers. In case a subpart conducts any HIPAA standard transactions by itself, without its parent's involvement, it must have its own NPI number.

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Identifiers

StateTypeNumberIssuer
All States NPI 1790179992 NPPES
Ohio Other 30023665 LICENSE NUMBER

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