| Upmc Braddock Dental Center | |
|
450 Holland Ave Suite 209 Braddock PA 15104-1536 | |
| (412) 636-5187 | |
| (412) 636-5248 |
| Full Name | Upmc Braddock Dental Center |
|---|---|
| Speciality | Dentist - General Practice |
| Location | 450 Holland Ave, Braddock, Pennsylvania |
| Authorized Official Name and Position | Mark S. Sevco (PRESIDENT) |
| Authorized Official Contact | 4126365100 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Upmc Braddock Dental Center 450 Holland Ave. Suite 209 Braddock PA 15104-1536 Ph: (412) 636-5187 | Upmc Braddock Dental Center 450 Holland Ave Suite 209 Braddock PA 15104-1536 Ph: (412) 636-5187 |
| NPI Number | 1457579773 |
|---|---|
| Provider Enumeration Date | 04/23/2007 |
| Last Update Date | 08/22/2020 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1457579773 | NPI | - | NPPES |
| 101566-1 | Medicaid | PA | |
| 1411127 | Other | PA | UNITED CONCORDIA |
| 1007360690010 | Medicaid | PA |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223G0001X | Dentist - General Practice | (* (Not Available)) | Primary |
Braddock Dental Center Of Upmc Presbyterian Shadyside Dental Clinic Medicare: Not Enrolled in Medicare Practice Location: 818 Braddock Ave, Braddock, PA 15104 Phone: 412-636-5187 Fax: 412-636-5248 |