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General NPI Number Information
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NPI Number | 1013093640
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Entity Type | Organization
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Legal Business Name | PEACE DENTAL, PC
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Dates
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Enumeration Date | 10/27/2006
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Last Update Date | 08/04/2009
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Provider Practice Location Address
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Address Line | 1509 MOUNT ROYAL BLVD
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City | GLENSHAW
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State | PA
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Zip | 15116-2207
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Country | US
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Telephone | 412-486-5155
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Fax | 412-487-3525
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Provider Business Mailing Address
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Address Line | 1509 MOUNT ROYAL BLVD
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City | GLENSHAW
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State | PA
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Zip | 15116-2207
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Country | US
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Telephone | 412-486-5155
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Fax | 412-487-3525
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Authorized Official
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Title or Position | DENTIST
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Name | ARNOLD M. PEACE
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Credential | D.M.D.
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Telephone | 412-486-5155
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1223G0001X
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Taxonomy Name | General Practice Dentistry
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License Number | DS025199L
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License Number State | PA
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