Provider Demographics
NPI:1851005789
Name:VALLEY VIEW PEDIATRIC DENTISTRY
Entity Type:Organization
Organization Name:VALLEY VIEW PEDIATRIC DENTISTRY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:DIANA
Authorized Official - Middle Name:
Authorized Official - Last Name:HAERR
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:724-825-4602
Mailing Address - Street 1:950 MANIFOLD RD STE 106
Mailing Address - Street 2:
Mailing Address - City:WASHINGTON
Mailing Address - State:PA
Mailing Address - Zip Code:15301-9602
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:950 MANIFOLD RD STE 106
Practice Address - Street 2:
Practice Address - City:WASHINGTON
Practice Address - State:PA
Practice Address - Zip Code:15301-9602
Practice Address - Country:US
Practice Address - Phone:724-825-4602
Practice Address - Fax:724-909-0896
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-01-05
Last Update Date:2023-01-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261Q00000XAmbulatory Health Care FacilitiesClinic/Center