Provider Demographics
NPI:1326367335
Name:GLAB, KATARZYNA (DMD)
Entity Type:Individual
Prefix:
First Name:KATARZYNA
Middle Name:
Last Name:GLAB
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 1:5306 BUTLER ST
Mailing Address - Street 2:APT. 2
Mailing Address - City:PITTSBURGH
Mailing Address - State:PA
Mailing Address - Zip Code:15201-2614
Mailing Address - Country:US
Mailing Address - Phone:864-360-5843
Mailing Address - Fax:
Practice Address - Street 1:4806 WILLIAM PENN HWY
Practice Address - Street 2:
Practice Address - City:EXPORT
Practice Address - State:PA
Practice Address - Zip Code:15632-9280
Practice Address - Country:US
Practice Address - Phone:724-325-1274
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-06-01
Last Update Date:2010-06-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PADS0381631223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty