MEDICARE: DR. MICHAEL ALLEN CUDDY DMD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	122300000X	Dentist	DS 029713 L	PA
2	1223D0004X	Dental Anesthesiology	DA-029713-A	PA

General Provider Information

NPI Number	:	1265417935
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. MICHAEL ALLEN CUDDY DMD

Provider Business Mailing Address
First Line	:	3501 TERRACE ST.
Second Line	:	G-89 SALK HALL
City	:	PITTSBURGH
State	:	PA
Zip	:	15261
Country	:	US
Telephone Number	:	412-648-8609
Fax Number	:

Provider Business Practice Location Address
First Line	:	3501 TERRACE ST.
Second Line	:	SUITE 3189
City	:	PITTSBURGH
State	:	PA
Zip	:	15261-0001
Country	:	US
Telephone Number	:	412-648-9100
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	12/14/2005
Last Update Date	:	06/06/2013

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