Provider Demographics
NPI:1932481868
Name:DR. JOHN L. WALDMAN
Entity Type:Organization
Organization Name:DR. JOHN L. WALDMAN
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:JOHN
Authorized Official - Middle Name:L
Authorized Official - Last Name:WALDMAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:412-391-3322
Mailing Address - Street 1:650 SMITHFIELD ST
Mailing Address - Street 2:1530 CENTRE CITY TOWER
Mailing Address - City:PITTSBURGH
Mailing Address - State:PA
Mailing Address - Zip Code:15222-3900
Mailing Address - Country:US
Mailing Address - Phone:412-391-3322
Mailing Address - Fax:412-391-5430
Practice Address - Street 1:650 SMITHFIELD ST
Practice Address - Street 2:1530 CENTRE CITY TOWER
Practice Address - City:PITTSBURGH
Practice Address - State:PA
Practice Address - Zip Code:15222-3900
Practice Address - Country:US
Practice Address - Phone:412-391-3322
Practice Address - Fax:412-391-5430
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-09-16
Last Update Date:2012-02-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PADS026624L1223P0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223P0700XDental ProvidersDentistProsthodonticsGroup - Single Specialty