Provider Demographics
NPI:1528034808
Name:PAGANO, CHARLES D (DMD)
Entity Type:Individual
Prefix:DR
First Name:CHARLES
Middle Name:D
Last Name:PAGANO
Suffix:
Gender:M
Credentials:DMD
Other - Prefix:
Other - First Name:
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Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:207 URICK LANE
Mailing Address - Street 2:
Mailing Address - City:MONROEVILLE
Mailing Address - State:PA
Mailing Address - Zip Code:15146
Mailing Address - Country:US
Mailing Address - Phone:412-373-0271
Mailing Address - Fax:412-646-2822
Practice Address - Street 1:207 URICK LANE
Practice Address - Street 2:
Practice Address - City:MONROEVILLE
Practice Address - State:PA
Practice Address - Zip Code:15146
Practice Address - Country:US
Practice Address - Phone:412-373-0271
Practice Address - Fax:412-646-2822
Is Sole Proprietor?:No
Enumeration Date:2006-02-27
Last Update Date:2016-04-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PADS0176221223X0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223X0400XDental ProvidersDentistOrthodontics and Dentofacial Orthopedics