Provider Demographics
NPI:1225304835
Name:HIGHLAND DENTAL
Entity Type:Organization
Organization Name:HIGHLAND DENTAL
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:ROLLIN
Authorized Official - Middle Name:
Authorized Official - Last Name:PRASAD
Authorized Official - Suffix:
Authorized Official - Credentials:DMD
Authorized Official - Phone:412-877-4886
Mailing Address - Street 1:5109 STATE ROUTE 30
Mailing Address - Street 2:SUITE A
Mailing Address - City:GREENSBURG
Mailing Address - State:PA
Mailing Address - Zip Code:15601-7750
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:5109 STATE ROUTE 30
Practice Address - Street 2:SUITE A
Practice Address - City:GREENSBURG
Practice Address - State:PA
Practice Address - Zip Code:15601-7750
Practice Address - Country:US
Practice Address - Phone:412-877-4886
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-03-28
Last Update Date:2012-03-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PADS035857261QD0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QD0000XAmbulatory Health Care FacilitiesClinic/CenterDental