Healthcare Provider Details

I. General information

NPI: 1396965497
Provider Name (Legal Business Name): DAVID PAUL DZUBAN DDS
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/30/2007
Last Update Date: 11/16/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

300 PENN CENTER BLVD STE 210
PITTSBURGH PA
15235-5502
US

IV. Provider business mailing address

300 PENN CENTER BLVD STE 210
PITTSBURGH PA
15235-5502
US

V. Phone/Fax

Practice location:
  • Phone: 412-367-3368
  • Fax: 412-367-0451
Mailing address:
  • Phone: 412-367-3368
  • Fax: 412-367-0451

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code332B00000X
TaxonomyDurable Medical Equipment & Medical Supplies
License NumberDS028795L
License Number StatePA
# 2
Primary TaxonomyY
Taxonomy Code122300000X
TaxonomyDentist
License NumberDS028795L
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: