MEDICARE: SOUTH HILLS DENTAL CARE COMPANY

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

General Provider Information

NPI Number	:	1639704513
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	SOUTH HILLS DENTAL CARE COMPANY

Provider Business Mailing Address
First Line	:	300 WEYMAN RD STE 260
Second Line	:
City	:	PITTSBURGH
State	:	PA
Zip	:	15236-1591
Country	:	US
Telephone Number	:	412-882-1320
Fax Number	:

Provider Business Practice Location Address
First Line	:	300 WEYMAN RD STE 260
Second Line	:
City	:	PITTSBURGH
State	:	PA
Zip	:	15236-1591
Country	:	US
Telephone Number	:	412-882-1320
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	DR. WILLIAM SCOTT POLING
Credential	:	DDS
Telephone Number	:	412-882-1320

Provider Enumeration Date	:	03/11/2020
Last Update Date	:	03/11/2020

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Directions to “SOUTH HILLS DENTAL CARE COMPANY ” Practice Location

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