Provider Demographics
NPI:1376890772
Name:STEVEN J SPECA DMD LLC
Entity Type:Organization
Organization Name:STEVEN J SPECA DMD LLC
Other - Org Name:DENTAL ANESTHESIA SOLUTIONS
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:STEVEN
Authorized Official - Middle Name:J
Authorized Official - Last Name:SPECA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:412-983-6663
Mailing Address - Street 1:125 FAIRWAY LANDINGS DR
Mailing Address - Street 2:
Mailing Address - City:CANONSBURG
Mailing Address - State:PA
Mailing Address - Zip Code:15317-9568
Mailing Address - Country:US
Mailing Address - Phone:412-983-6663
Mailing Address - Fax:
Practice Address - Street 1:125 FAIRWAY LANDINGS DR
Practice Address - Street 2:
Practice Address - City:CANONSBURG
Practice Address - State:PA
Practice Address - Zip Code:15317-9568
Practice Address - Country:US
Practice Address - Phone:412-983-6663
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-08-06
Last Update Date:2012-09-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PADS0360646122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Single Specialty