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General NPI Number Information
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NPI Number | 1316111008
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Entity Type | Organization
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Legal Business Name | DEMETRIOS PATRINOS DMD MD PC
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Dates
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Enumeration Date | 04/15/2008
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Last Update Date | 04/15/2008
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Provider Practice Location Address
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Address Line | 2585 WASHINGTON RD SUITE 111
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City | PITTSBURGH
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State | PA
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Zip | 15241-2565
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Country | US
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Telephone | 412-833-3331
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Fax | 412-833-2485
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Provider Business Mailing Address
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Address Line | 2585 WASHINGTON RD SUITE 111
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City | PITTSBURGH
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State | PA
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Zip | 15241-2565
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Country | US
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Telephone | 412-833-3331
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Fax | 412-833-2485
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. DEMETRIOS C. PATRINOS
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Credential | DMD, MD
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Telephone | 412-833-3331
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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 | DS028322L
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License Number State | PA
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