Provider Demographics
NPI:1033505474
Name:POLISHED DENTAL GROUP
Entity Type:Organization
Organization Name:POLISHED DENTAL GROUP
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DENTIST/OWNER
Authorized Official - Prefix:
Authorized Official - First Name:JOSEPH
Authorized Official - Middle Name:
Authorized Official - Last Name:TROUPE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:412-823-5252
Mailing Address - Street 1:990 ROLAND RD
Mailing Address - Street 2:
Mailing Address - City:PITTSBURGH
Mailing Address - State:PA
Mailing Address - Zip Code:15221-3962
Mailing Address - Country:US
Mailing Address - Phone:412-823-5252
Mailing Address - Fax:
Practice Address - Street 1:990 ROLAND RD
Practice Address - Street 2:
Practice Address - City:PITTSBURGH
Practice Address - State:PA
Practice Address - Zip Code:15221-3962
Practice Address - Country:US
Practice Address - Phone:412-823-5252
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-04-13
Last Update Date:2015-04-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PADS0387931223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty