MEDICARE: DENTAL & DENTURES PITTSBURGH INC

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		PA

General Provider Information

NPI Number	:	1477096212
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	DENTAL & DENTURES PITTSBURGH INC

Provider Business Mailing Address
First Line	:	8700 PENNSYLVANIA AVE
Second Line	:
City	:	N HUNTINGDON
State	:	PA
Zip	:	15642-2762
Country	:	US
Telephone Number	:	724-864-0070
Fax Number	:	724-864-8520

Provider Business Practice Location Address
First Line	:	8700 PENNSYLVANIA AVE
Second Line	:
City	:	N HUNTINGDON
State	:	PA
Zip	:	15642-2762
Country	:	US
Telephone Number	:	724-864-0070
Fax Number	:	724-864-8520

Authorized Official
Title or Position	:	DIRECTOR
Name	:	DOUGLAS J CLOSINSKI
Credential	:
Telephone Number	:	518-376-6328

Provider Enumeration Date	:	11/28/2016
Last Update Date	:	11/28/2016

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