Healthcare Provider Details

I. General information

NPI: 1922339670
Provider Name (Legal Business Name): LARRY B MANALO II DMD
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/20/2010
Last Update Date: 01/27/2026
Certification Date: 01/27/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1580 MCLAUGHLIN RUN ROAD #118
PITTSBURGH PA
15241
US

IV. Provider business mailing address

1580 MCLAUGHLIN RUN ROAD #118
PITTSBURGH PA
15241
US

V. Phone/Fax

Practice location:
  • Phone: 412-221-2221
  • Fax:
Mailing address:
  • Phone: 412-221-2221
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code122300000X
TaxonomyDentist
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code1223G0001X
TaxonomyGeneral Practice Dentistry
License Number
License Number State

VIII. Authorized Official

Name: MRS. CATHLEEN C MANALO
Title or Position: MANAGER
Credential:
Phone: 412-221-2221