MEDICARE: MARYANN DAVIS, DMD & ASSOCIATES, LLC.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	122300000X	Dentist	DS020711L	PA

General Provider Information

NPI Number	:	1003062910
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	MARYANN DAVIS, DMD & ASSOCIATES, LLC.

Provider Business Mailing Address
First Line	:	329 SADDLE BROOK ROAD
Second Line	:
City	:	GIBSONIA
State	:	PA
Zip	:	15044-7809
Country	:	US
Telephone Number	:	724-444-0620
Fax Number	:	724-444-0620

Provider Business Practice Location Address
First Line	:	3808 BRIGHTON ROAD
Second Line	:	SUITE 1
City	:	PITTSBURGH
State	:	PA
Zip	:	15212-1677
Country	:	US
Telephone Number	:	412-766-3100
Fax Number	:	412-766-3100

Authorized Official
Title or Position	:	OWNER - DENTIST
Name	:	DR. MARY ANN DAVIS
Credential	:	DMD
Telephone Number	:	412-766-3100

Provider Enumeration Date	:	08/12/2008
Last Update Date	:	09/21/2011

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