Healthcare Provider Details

I. General information

NPI: 1184680191
Provider Name (Legal Business Name): MICHAEL J DUGAN D.M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/26/2006
Last Update Date: 06/28/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9401 MCKNIGHT RD SUITE 201
PITTSBURGH PA
15237-6000
US

IV. Provider business mailing address

9401 MCKNIGHT RD SUITE 201
PITTSBURGH PA
15237-6000
US

V. Phone/Fax

Practice location:
  • Phone: 412-366-2090
  • Fax: 412-366-3477
Mailing address:
  • Phone: 412-366-2090
  • Fax: 412-366-3477

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223S0112X
TaxonomyOral and Maxillofacial Surgery (Dentist)
License NumberDS026382L
License Number StatePA
# 2
Primary TaxonomyN
Taxonomy Code207L00000X
TaxonomyAnesthesiology Physician
License NumberDA026382A
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: