Upmc Presbyterian Shadyside | |
3459 5th Ave Suite 202 South Pittsburgh PA 15213-3236 | |
(412) 648-6080 | |
(412) 648-6798 |
Full Name | Upmc Presbyterian Shadyside |
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Speciality | Dentist - Oral And Maxillofacial Surgery |
Location | 3459 5th Ave, Pittsburgh, Pennsylvania |
Authorized Official Name and Position | Catherine Teresa Smith (ADMINISTRATIVE COORDINATOR) |
Authorized Official Contact | 4126486080 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
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Upmc Presbyterian Shadyside 3459 5th Ave Suite 202 South Pittsburgh PA 15213-3236 Ph: (412) 648-6080 | Upmc Presbyterian Shadyside 3459 5th Ave Suite 202 South Pittsburgh PA 15213-3236 Ph: (412) 648-6080 |
NPI Number | 1043392855 |
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Provider Enumeration Date | 10/20/2006 |
Last Update Date | 08/22/2020 |
Identifier | Type | State | Issuer |
---|---|---|---|
1043392855 | NPI | - | NPPES |
1000019040145 | Medicaid | PA |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
1223P0700X | Dentist - Prosthodontics | DS027010L (Pennsylvania) | Primary |
1223S0112X | Dentist - Oral And Maxillofacial Surgery | DS029690L (Pennsylvania) | Primary |
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