Provider Demographics
NPI:1134497233
Name:CAIN, COLLEEN ROSE (DMD)
Entity Type:Individual
Prefix:DR
First Name:COLLEEN
Middle Name:ROSE
Last Name:CAIN
Suffix:
Gender:F
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3757 LIBRARY RD
Mailing Address - Street 2:
Mailing Address - City:PITTSBURGH
Mailing Address - State:PA
Mailing Address - Zip Code:15234
Mailing Address - Country:US
Mailing Address - Phone:412-343-9999
Mailing Address - Fax:412-343-2939
Practice Address - Street 1:3757 LIBRARY RD
Practice Address - Street 2:
Practice Address - City:PITTSBURGH
Practice Address - State:PA
Practice Address - Zip Code:15234
Practice Address - Country:US
Practice Address - Phone:412-343-9999
Practice Address - Fax:412-343-2939
Is Sole Proprietor?:Yes
Enumeration Date:2011-12-05
Last Update Date:2018-02-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PADS0382681223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice