Provider Demographics
NPI:1174634844
Name:WESTMORELAND DENTAL APPLIANCES INC
Entity Type:Organization
Organization Name:WESTMORELAND DENTAL APPLIANCES INC
Other - Org Name:FAY WEST DENTAL CENTER AND BRITESMILE
Other - Org Type:Other Name
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:JAMES
Authorized Official - Middle Name:EUGENE
Authorized Official - Last Name:NICOLETTE
Authorized Official - Suffix:
Authorized Official - Credentials:DMD
Authorized Official - Phone:724-887-3060
Mailing Address - Street 1:111 CROSSROADS ROAD
Mailing Address - Street 2:
Mailing Address - City:SCOTTDALE
Mailing Address - State:PA
Mailing Address - Zip Code:15683
Mailing Address - Country:US
Mailing Address - Phone:724-887-3060
Mailing Address - Fax:724-887-3945
Practice Address - Street 1:111 CROSSROADS ROAD
Practice Address - Street 2:
Practice Address - City:SCOTTDALE
Practice Address - State:PA
Practice Address - Zip Code:15683
Practice Address - Country:US
Practice Address - Phone:724-887-3060
Practice Address - Fax:724-887-3945
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-31
Last Update Date:2008-06-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PA014087122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Multi-Specialty