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General NPI Number Information
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NPI Number | 1457967770
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Entity Type | Organization
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Legal Business Name | PEARL DENTISTRY OF BUTLER PLLC
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Dates
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Enumeration Date | 09/22/2020
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Last Update Date | 09/22/2020
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Provider Practice Location Address
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Address Line | 101 OAK RIDGE DR
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City | BUTLER
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State | PA
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Zip | 16002-4901
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Country | US
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Telephone | 724-283-2848
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Fax |
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Provider Business Mailing Address
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Address Line | 101 OAK RIDGE DR
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City | BUTLER
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State | PA
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Zip | 16002-4901
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Country | US
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Telephone | 724-283-2848
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Fax | 724-283-3899
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Authorized Official
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Title or Position | DENTIST
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Name | DR. MATTHEW LEE WEISS
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Credential | MD
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Telephone | 412-926-8201
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 122300000X
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Taxonomy Name | Dentist
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License Number |
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License Number State |
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