Healthcare Provider Details

I. General information

NPI: 1841346822
Provider Name (Legal Business Name): ALLEGHENY ENDODONTICS LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/25/2007
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

86 FT COUCH RD ALLEGHENY ENDODONTIC SPECIALISTS INC
PITTSBURGH PA
15241
US

IV. Provider business mailing address

86 FT COUCH RD ALLEGHENY ENDODONTIC SPECIALISTS INC
PITTSBURGH PA
15241
US

V. Phone/Fax

Practice location:
  • Phone: 412-833-9540
  • Fax: 412-833-4525
Mailing address:
  • Phone: 412-833-9540
  • Fax: 412-833-4525

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223E0200X
TaxonomyEndodontics
License NumberDS035341
License Number StatePA

VIII. Authorized Official

Name: DR. DAVID JAMES HARRIS JR.
Title or Position: ENDODONTIST
Credential: DDS MSD
Phone: 412-833-9540