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General NPI Number Information
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NPI Number | 1124428347
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Entity Type | Organization
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Legal Business Name | MNM DENTAL GROUP
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Dates
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Enumeration Date | 08/25/2014
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Last Update Date | 08/25/2014
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Provider Practice Location Address
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Address Line | 355 5TH AVE STE 1520
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City | PITTSBURGH
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State | PA
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Zip | 15222-2418
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Country | US
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Telephone | 412-281-9411
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Fax |
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Provider Business Mailing Address
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Address Line | 355 5TH AVE STE 1520
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City | PITTSBURGH
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State | PA
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Zip | 15222-2418
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Country | US
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Telephone | 412-281-9411
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | DR. NICHOLAS A MANGINI
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Credential | DMD
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Telephone | 412-281-9411
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1223P0700X
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Taxonomy Name | Prosthodontics
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License Number | DS038395
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License Number State | PA
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