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General NPI Number Information
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NPI Number | 1174794051
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Entity Type | Organization
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Legal Business Name | LARRY E. MANALO DMD
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Dates
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Enumeration Date | 03/18/2008
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Last Update Date | 11/22/2013
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Provider Practice Location Address
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Address Line | 1580 MCLAUGHLIN RUN RD STE 118
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City | PITTSBURGH
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State | PA
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Zip | 15241-3100
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Country | US
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Telephone | 412-221-2221
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Fax |
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Provider Business Mailing Address
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Address Line | 1580 MCLAUGHLIN RUN RD STE 118
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City | PITTSBURGH
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State | PA
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Zip | 15241-3100
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Country | US
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Telephone | 412-221-2221
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Fax |
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Authorized Official
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Title or Position | DENTIST/OWNER
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Name | DR. LARRY E MANALO II
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Credential | DMD
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Telephone | 412-221-2221
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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 | DS027433L
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License Number State | PA
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