MEDICARE: DR. JOSEPH MICHAEL VALENTICH DMD

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	DS022927L	PA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	004535	OTHER	PA	DORAL

General Provider Information

NPI Number	:	1124001524
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. JOSEPH MICHAEL VALENTICH DMD

Provider Business Mailing Address
First Line	:	11743 FRANKSTOWN RD
Second Line	:
City	:	PITTSBURGH
State	:	PA
Zip	:	15235-3442
Country	:	US
Telephone Number	:	412-371-2558
Fax Number	:	412-371-5272

Provider Business Practice Location Address
First Line	:	11743 FRANKSTOWN RD
Second Line	:
City	:	PITTSBURGH
State	:	PA
Zip	:	15235-3442
Country	:	US
Telephone Number	:	412-371-2558
Fax Number	:	412-371-5272

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	11/21/2005
Last Update Date	:	07/08/2007

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