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General NPI Number Information
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NPI Number | 1720968639
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Entity Type | Organization
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Legal Business Name | PROFESSIONAL DENTAL ALLIANCE OF CROSSVILLE, PLLC
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Dates
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Enumeration Date | 09/03/2025
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Last Update Date | 09/18/2025
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Provider Practice Location Address
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Address Line | 125 COOL SPRINGS BLVD STE 140
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City | FRANKLIN
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State | TN
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Zip | 37067-6475
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Country | US
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Telephone | 615-771-1111
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Fax |
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Provider Business Mailing Address
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Address Line | 125 ENTERPRISE DR STE 200
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City | PITTSBURGH
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State | PA
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Zip | 15275-1223
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | CREDENTIALING
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Name | ERICA QUINTEROS
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Credential |
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Telephone | 724-901-1964
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1223X0400X
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Taxonomy Name | Orthodontics and Dentofacial Orthopedics Dentistry
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License Number |
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License Number State |
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