Healthcare Provider Details

I. General information

NPI: 1548562234
Provider Name (Legal Business Name): SQUIRREL HILL HEALTH CENTER DENTAL
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/01/2010
Last Update Date: 12/31/2020
Certification Date: 12/31/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4516 BROWNS HILL RD
PITTSBURGH PA
15217-2917
US

IV. Provider business mailing address

4516 BROWNS HILL RD
PITTSBURGH PA
15217-2917
US

V. Phone/Fax

Practice location:
  • Phone: 412-422-7442
  • Fax: 412-904-5025
Mailing address:
  • Phone: 412-422-7442
  • Fax: 412-904-5025

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223G0001X
TaxonomyGeneral Practice Dentistry
License Number
License Number State

VIII. Authorized Official

Name: SUSAN FRIEDBERG KALSON
Title or Position: CEO
Credential:
Phone: 412-422-7442