Provider Demographics
NPI:1679964811
Name:DENT-AL SMILES MANAGMENT GROUP, LLC
Entity Type:Organization
Organization Name:DENT-AL SMILES MANAGMENT GROUP, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MEMBER
Authorized Official - Prefix:
Authorized Official - First Name:ALVARO
Authorized Official - Middle Name:
Authorized Official - Last Name:LAZO
Authorized Official - Suffix:
Authorized Official - Credentials:DMD
Authorized Official - Phone:412-779-4235
Mailing Address - Street 1:242 S HIGHLAND AVE
Mailing Address - Street 2:SUITE 201
Mailing Address - City:PITTSBURGH
Mailing Address - State:PA
Mailing Address - Zip Code:15206-3937
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:242 S HIGHLAND AVE
Practice Address - Street 2:SUITE 201
Practice Address - City:PITTSBURGH
Practice Address - State:PA
Practice Address - Zip Code:15206-3937
Practice Address - Country:US
Practice Address - Phone:412-661-7316
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-02-10
Last Update Date:2015-02-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QD0000XAmbulatory Health Care FacilitiesClinic/CenterDental