Healthcare Provider Details

I. General information

NPI: 1285021899
Provider Name (Legal Business Name): JOHN S WARWICK III
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/21/2015
Last Update Date: 04/21/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

500 GRANT ST UPPR LOBBY
PITTSBURGH PA
15219-2502
US

IV. Provider business mailing address

500 GRANT ST UPPR LOBBY
PITTSBURGH PA
15219-2502
US

V. Phone/Fax

Practice location:
  • Phone: 412-391-1130
  • Fax:
Mailing address:
  • Phone: 412-391-1130
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code122300000X
TaxonomyDentist
License Number025782
License Number StatePA
# 2
Primary TaxonomyN
Taxonomy Code332BC3200X
TaxonomyCustomized Equipment (DME)
License Number
License Number State

VIII. Authorized Official

Name: DR. JOHN S WARWICK III
Title or Position: OWNER
Credential: DMD
Phone: 412-996-5519