Provider Demographics
NPI:1174185847
Name:GAROFALO, SUZANNE (PHDHP, RDH, MBA)
Entity Type:Individual
Prefix:
First Name:SUZANNE
Middle Name:
Last Name:GAROFALO
Suffix:
Gender:F
Credentials:PHDHP, RDH, MBA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1527 WINDCREST DR
Mailing Address - Street 2:
Mailing Address - City:PITTSBURGH
Mailing Address - State:PA
Mailing Address - Zip Code:15206-1366
Mailing Address - Country:US
Mailing Address - Phone:412-377-4627
Mailing Address - Fax:412-361-2651
Practice Address - Street 1:1527 WINDCREST DR
Practice Address - Street 2:
Practice Address - City:PITTSBURGH
Practice Address - State:PA
Practice Address - Zip Code:15206-1366
Practice Address - Country:US
Practice Address - Phone:412-377-4627
Practice Address - Fax:412-361-2651
Is Sole Proprietor?:Yes
Enumeration Date:2019-07-02
Last Update Date:2019-07-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PADH007120L124Q00000X
PAPHDH001099124Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes124Q00000XDental ProvidersDental Hygienist