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General NPI Number Information
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NPI Number | 1982398806
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Entity Type | Organization
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Legal Business Name | PREMIER DENTAL ALLIANCE LLC
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Dates
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Enumeration Date | 06/05/2023
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Last Update Date | 06/05/2023
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Provider Practice Location Address
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Address Line | 211 LAUREL AVE
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City | CRESSON
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State | PA
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Zip | 16630-1118
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Country | US
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Telephone | 814-886-5406
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Fax | 814-886-5547
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Provider Business Mailing Address
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Address Line | 211 LAUREL AVE
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City | CRESSON
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State | PA
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Zip | 16630-1118
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Country | US
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Telephone | 814-886-5406
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Fax | 814-886-5547
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Authorized Official
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Title or Position | DENTIST/OWNER
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Name | DR. JOSHUA A PARRY
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Credential | DMD
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Telephone | 724-836-3368
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QD0000X
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Taxonomy Name | Dental Clinic/Center
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License Number |
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License Number State |
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