Provider Demographics
NPI:1043652746
Name:DANIEL J. SPELLMAN DMD PC
Entity Type:Organization
Organization Name:DANIEL J. SPELLMAN DMD PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRES/SECR
Authorized Official - Prefix:DR
Authorized Official - First Name:DANIEL
Authorized Official - Middle Name:J
Authorized Official - Last Name:SPELLMAN
Authorized Official - Suffix:
Authorized Official - Credentials:DMD
Authorized Official - Phone:412-464-1976
Mailing Address - Street 1:4117 MAIN ST
Mailing Address - Street 2:
Mailing Address - City:MUNHALL
Mailing Address - State:PA
Mailing Address - Zip Code:15120-3327
Mailing Address - Country:US
Mailing Address - Phone:412-464-1976
Mailing Address - Fax:412-464-0426
Practice Address - Street 1:4117 MAIN ST
Practice Address - Street 2:
Practice Address - City:MUNHALL
Practice Address - State:PA
Practice Address - Zip Code:15120-3327
Practice Address - Country:US
Practice Address - Phone:412-464-1976
Practice Address - Fax:412-464-0426
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-07-23
Last Update Date:2013-07-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PADSO2OO66L261QD0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QD0000XAmbulatory Health Care FacilitiesClinic/CenterDental