Provider Demographics
NPI:1811042625
Name:DENTISTRY FOR KIDS
Entity Type:Organization
Organization Name:DENTISTRY FOR KIDS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:VICE PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:MATTHEW
Authorized Official - Middle Name:J
Authorized Official - Last Name:PRICE
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:412-856-6660
Mailing Address - Street 1:2790 MOSSIDE BLVD
Mailing Address - Street 2:SUITE 140
Mailing Address - City:MONROEVILLE
Mailing Address - State:PA
Mailing Address - Zip Code:15146-2743
Mailing Address - Country:US
Mailing Address - Phone:412-856-6660
Mailing Address - Fax:412-856-1463
Practice Address - Street 1:2790 MOSSIDE BLVD
Practice Address - Street 2:SUITE 140
Practice Address - City:MONROEVILLE
Practice Address - State:PA
Practice Address - Zip Code:15146-2743
Practice Address - Country:US
Practice Address - Phone:412-856-6660
Practice Address - Fax:412-856-1463
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-24
Last Update Date:2009-10-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223P0221XDental ProvidersDentistPediatric DentistryGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA168120OtherUNITED CONCORDIA NUMBER