Provider Demographics
NPI:1144239013
Name:NOVA DENTAL ASSOCIATES, PC
Entity Type:Organization
Organization Name:NOVA DENTAL ASSOCIATES, PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EXEC. ASSISTANT
Authorized Official - Prefix:MS
Authorized Official - First Name:DIANE
Authorized Official - Middle Name:H
Authorized Official - Last Name:MEHALL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:412-784-1522
Mailing Address - Street 1:369 BUTLER STREET
Mailing Address - Street 2:PO BOX 9507
Mailing Address - City:PITTSBURGH
Mailing Address - State:PA
Mailing Address - Zip Code:15223
Mailing Address - Country:US
Mailing Address - Phone:412-784-1522
Mailing Address - Fax:412-784-0995
Practice Address - Street 1:369 BUTLER ST
Practice Address - Street 2:
Practice Address - City:PITTSBURGH
Practice Address - State:PA
Practice Address - Zip Code:15223-2124
Practice Address - Country:US
Practice Address - Phone:412-784-1522
Practice Address - Fax:412-784-0995
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:NOVA DENTAL ASSOCIATES, P.C.
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2006-08-07
Last Update Date:2008-03-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty