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NPI Code Detail

MEDICARE: DATTILO AND HALL LLC

MEDICARE: DATTILO AND HALL 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
11223S0112XOral and Maxillofacial Surgery (Dentist)

General Provider Information

NPI Number : 1710999339
Entity Type Code : Organization
Provider Name (Legal Business Name) : DATTILO AND HALL LLC
Provider Business Mailing Address
First Line : 305 MOUNT LEBANON BLVD
Second Line :
City : PITTSBURGH
State : PA
Zip : 15234-1511
Country : US
Telephone Number : 412-563-7707
Fax Number : 412-563-0970
Provider Business Practice Location Address
First Line : 305 MOUNT LEBANON BLVD
Second Line : 305
City : PITTSBURGH
State : PA
Zip : 15234-1511
Country : US
Telephone Number : 412-563-7707
Fax Number : 412-563-0970
Authorized Official
Title or Position : ORAL MAXILLOFACIAL SURGEON
Name : DR. DAVID JAMES DATTILO
Credential : DMD
Telephone Number : 412-563-7707
Provider Enumeration Date : 08/12/2006
Last Update Date : 12/02/2009

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Directions to “DATTILO AND HALL LLC ” Practice Location

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