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General NPI Number Information
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NPI Number | 1831900562
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Entity Type | Organization
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Legal Business Name | PEARL DENTISTRY OF MOON, PLLC
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Dates
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Enumeration Date | 01/14/2025
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Last Update Date | 01/14/2025
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Provider Practice Location Address
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Address Line | 934 BEAVER GRADE RD
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City | CORAOPOLIS
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State | PA
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Zip | 15108-2716
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Country | US
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Telephone | 412-264-1888
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Fax |
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Provider Business Mailing Address
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Address Line | 121 LYNDHURST CIR
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City | WEXFORD
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State | PA
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Zip | 15090-8870
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | OWNER/DENTIST
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Name | DR. MATTHEW L WEISS
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Credential | DMD
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Telephone | 304-771-2374
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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 |
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License Number State |
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