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General NPI Number Information
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NPI Number | 1205546496
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Entity Type | Organization
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Legal Business Name | ADVANCED DENTAL SPECIALTIES
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Dates
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Enumeration Date | 11/29/2022
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Last Update Date | 11/30/2022
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Provider Practice Location Address
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Address Line | 100 CORPORATE CENTER DR
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City | CORAOPOLIS
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State | PA
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Zip | 15108-4331
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Country | US
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Telephone | 412-262-1001
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Fax |
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Provider Business Mailing Address
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Address Line | 100 CORPORATE CENTER DR
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City | CORAOPOLIS
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State | PA
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Zip | 15108-4331
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | DONALD CHAPMAN
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Credential | DDS
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Telephone | 304-312-4884
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1223P0300X
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Taxonomy Name | Periodontics
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License Number |
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License Number State |
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