Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Professional Dental Alliance of Tx 43004 PLLC

Organization General Practice Dentistry · NPI 1093329534

Professional Dental Alliance of Tx 43004 PLLC is a General Practice Dentistry in Tyler, Texas. Registered with an NPI since 2020.

In the registry since
2020
What do these letters mean?
PLLC — Professional limited liability company
A form of business registration, not a clinical qualification.

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Practice location Address checks out

212 Old Grande Blvd Ste B224
Tyler, TX 75703-4277
Phone: (903) 509-0505
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

General Practice Dentistry (primary) Taxonomy 1223G0001X

Record details

NPI number1093329534
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official Lauren Howard — Credentialing Specialist · (757) 576-5479
NPI enumeratedSeptember 2, 2020
Last updated in NPPESSeptember 2, 2020
Certification dateSeptember 2, 2020
Mailing address11 S Mill St, New Castle, PA 16101-3680

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