Healthcare Provider Details

I. General information

NPI: 1669818472
Provider Name (Legal Business Name): PITTSBURGH DENTAL ASSOCIATES, L.L.C.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/20/2013
Last Update Date: 07/16/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4701 BAPTIST RD SUITE 100
PITTSBURGH PA
15227-1117
US

IV. Provider business mailing address

315 DUTCH LN
PITTSBURGH PA
15236-4330
US

V. Phone/Fax

Practice location:
  • Phone: 412-884-7757
  • Fax:
Mailing address:
  • Phone: 412-370-6316
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code124Q00000X
TaxonomyDental Hygienist
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code122300000X
TaxonomyDentist
License Number
License Number State

VIII. Authorized Official

Name: DR. DAVID ANDROS
Title or Position: OWNER
Credential: D.D.S.
Phone: 412-370-6316