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General NPI Number Information
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NPI Number | 1033230511
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Entity Type | Organization
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Legal Business Name | RICHARD A. DUKOVICH, D.M.D.
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Dates
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Enumeration Date | 04/03/2007
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 4880 LIBRARY RD STE F
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City | BETHEL PARK
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State | PA
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Zip | 15102-2946
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Country | US
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Telephone | 412-831-3853
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Fax | 412-831-7425
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Provider Business Mailing Address
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Address Line | 4880 LIBRARY RD STE F
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City | BETHEL PARK
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State | PA
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Zip | 15102-2946
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Country | US
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Telephone | 412-831-3853
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Fax | 412-831-7425
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Authorized Official
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Title or Position | DENTIST OWNER
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Name | RICHARD A. DUKOVICH
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Credential | D.M.D.
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Telephone | 412-831-3853
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 122300000X
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Taxonomy Name | Dentist
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License Number | DS036422L
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License Number State | PA
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Taxonomy #2
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Taxonomy Code | 122300000X
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Taxonomy Name | Dentist
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License Number | DS025717L
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License Number State | PA
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