Healthcare Provider Details

I. General information

NPI: 1275091886
Provider Name (Legal Business Name): GARY M CARMASSI DMD
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/04/2019
Last Update Date: 06/13/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8650 BABCOCK BLVD STE 3
PITTSBURGH PA
15237-5009
US

IV. Provider business mailing address

8650 BABCOCK BLVD
PITTSBURGH PA
15237-5009
US

V. Phone/Fax

Practice location:
  • Phone: 412-367-4515
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223S0112X
TaxonomyOral and Maxillofacial Surgery (Dentist)
License Number
License Number State

VIII. Authorized Official

Name: NIKHIL SAHA
Title or Position: PRESIDENT AND CEO
Credential:
Phone: 908-533-4386