| NPI | 1700849742 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DENISE NOEL Director Provider Enrollment 412-770-6871 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist General Practice |
| Additional Taxonomies | 1223D0001X Dentist Dental Public Health |
| 1223P0221X Dentist Pediatric Dentistry | |
| 1223S0112X Dentist Oral and Maxillofacial Surgery | |
| 261QD0000X Clinic/Center Dental | |
| Enumeration Date | 2006-04-10 |
| Last Update Date | 2022-10-12 |