Healthcare Provider Details

I. General information

NPI: 1134218589
Provider Name (Legal Business Name): ROBERT A. NASSIF JR. DMD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/12/2006
Last Update Date: 06/02/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2 PARKWAY CTR SUITE G-1
PITTSBURGH PA
15220-3510
US

IV. Provider business mailing address

305 PINTO PL
MARS PA
16046-2153
US

V. Phone/Fax

Practice location:
  • Phone: 412-937-1900
  • Fax: 412-937-9014
Mailing address:
  • Phone: 724-772-8889
  • Fax: 724-772-8922

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223D0004X
TaxonomyDental Anesthesiology
License NumberDA028723A
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: