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General NPI Number Information
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NPI Number | 1790814366
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Entity Type | Organization
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Legal Business Name | UPMC CHILDREN'S HOSPITAL OF PITTSBURGH DENTAL PROGRAM
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Dates
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Enumeration Date | 03/02/2007
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Last Update Date | 07/31/2018
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Provider Practice Location Address
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Address Line | 3705 5TH AVE GROUND FLOOR
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City | PITTSBURGH
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State | PA
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Zip | 15213
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Country | US
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Telephone | 412-692-5440
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Fax | 412-692-5335
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Provider Business Mailing Address
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Address Line | PO BOX 382007
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City | PITTSBURGH
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State | PA
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Zip | 15251-8007
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Country | US
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Telephone | 412-692-5440
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Fax | 412-692-5335
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Authorized Official
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Title or Position | MANAGER
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Name | THOMAS E SCOTT
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Credential |
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Telephone | 412-692-6805
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QD0000X
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Taxonomy Name | Dental Clinic/Center
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License Number | DS016769L
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License Number State | PA
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