Healthcare Provider Details

I. General information

NPI: 1649297334
Provider Name (Legal Business Name): BRIAN P. BUZZATTO DMD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/17/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

12 EASTERN AVE
PITTSBURGH PA
15215-3038
US

IV. Provider business mailing address

12 EASTERN AVE
PITTSBURGH PA
15215-3038
US

V. Phone/Fax

Practice location:
  • Phone: 412-781-5588
  • Fax:
Mailing address:
  • Phone: 412-781-5588
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223G0001X
TaxonomyGeneral Practice Dentistry
License NumberDS025534-L
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: