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General NPI Number Information
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NPI Number | 1386750610
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Entity Type | Individual
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Provider Name | JOAN MARIA WALLISCH D.M.D.
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Gender | Female
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Dates
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Enumeration Date | 08/21/2006
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Last Update Date | 03/26/2025
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Provider Practice Location Address
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Address Line | 1010 DELAFIELD RD
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City | PITTSBURGH
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State | PA
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Zip | 15215-1802
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Country | US
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Telephone | 412-822-2154
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Fax |
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Provider Business Mailing Address
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Address Line | 108 EASTERN AVE
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City | PITTSBURGH
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State | PA
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Zip | 15215-3028
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Country | US
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Telephone | 412-287-8084
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1223G0001X
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Taxonomy Name | General Practice Dentistry
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License Number | DS029700-L
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License Number State | PA
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