Provider Demographics
NPI:1093871253
Name:BLOCK, HARVEY M (DMDFAGD)
Entity Type:Individual
Prefix:
First Name:HARVEY
Middle Name:M
Last Name:BLOCK
Suffix:
Gender:M
Credentials:DMDFAGD
Other - Prefix:DR
Other - First Name:HARVEY
Other - Middle Name:M
Other - Last Name:BLOCK
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:DMDFAGD
Mailing Address - Street 1:7501 PENN AVE
Mailing Address - Street 2:
Mailing Address - City:PITTSBURGH
Mailing Address - State:PA
Mailing Address - Zip Code:15208-2560
Mailing Address - Country:US
Mailing Address - Phone:412-247-1007
Mailing Address - Fax:412-247-1026
Practice Address - Street 1:7501 PENN AVE
Practice Address - Street 2:
Practice Address - City:PITTSBURGH
Practice Address - State:PA
Practice Address - Zip Code:15208-2560
Practice Address - Country:US
Practice Address - Phone:412-247-1007
Practice Address - Fax:412-247-1026
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-29
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PADS024463L1223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA146729Medicare ID - Type UnspecifiedUNITED CONCORDIA