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General NPI Number Information
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NPI Number | 1205941465
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Entity Type | Organization
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Legal Business Name | DANIEL W. PITUCH, DMD, MD, PC
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Dates
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Enumeration Date | 08/20/2006
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 575 COAL VALLEY RD SUITE 316
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City | JEFFERSON HILLS
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State | PA
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Zip | 15025-3730
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Country | US
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Telephone | 412-469-7466
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Fax | 412-469-7467
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Provider Business Mailing Address
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Address Line | 575 COAL VALLEY RD SUITE 316
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City | JEFFERSON HILLS
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State | PA
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Zip | 15025-3730
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Country | US
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Telephone | 412-469-7466
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Fax | 412-469-7467
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. DANIEL W PITUCH
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Credential | DMD, MD
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Telephone | 412-469-7466
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1223S0112X
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Taxonomy Name | Oral and Maxillofacial Surgery (Dentist)
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License Number | DS035466
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License Number State | PA
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Taxonomy #2
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Taxonomy Code | 1223S0112X
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Taxonomy Name | Oral and Maxillofacial Surgery (Dentist)
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License Number | DS027222
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License Number State | PA
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