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General NPI Number Information
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NPI Number | 1295097442
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Entity Type | Organization
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Legal Business Name | ROBERT A PETCASH DMD PC
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Dates
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Enumeration Date | 06/13/2012
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Last Update Date | 01/08/2013
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Provider Practice Location Address
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Address Line | 2879 W HARDIES RD
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City | GIBSONIA
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State | PA
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Zip | 15044-8203
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Country | US
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Telephone | 724-444-7770
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Fax | 724-444-7676
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Provider Business Mailing Address
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Address Line | 2879 W HARDIES RD
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City | GIBSONIA
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State | PA
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Zip | 15044-8203
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Country | US
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Telephone | 724-444-7770
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Fax | 724-444-7676
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Authorized Official
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Title or Position | CEO
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Name | DR. ROBERT A PETCASH
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Credential | DMD
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Telephone | 724-444-7770
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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 | 027733
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License Number State | PA
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