Provider Demographics
NPI:1245257765
Name:PRECISION ENDODONTICS, LLC
Entity type:Organization
Organization Name:PRECISION ENDODONTICS, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:MATTHEW
Authorized Official - Middle Name:
Authorized Official - Last Name:DIANDRETH
Authorized Official - Suffix:
Authorized Official - Credentials:DMD
Authorized Official - Phone:412-366-6990
Mailing Address - Street 1:4725 MCKNIGHT RD
Mailing Address - Street 2:SUITE 222
Mailing Address - City:PITTSBURGH
Mailing Address - State:PA
Mailing Address - Zip Code:15237-3414
Mailing Address - Country:US
Mailing Address - Phone:412-366-6990
Mailing Address - Fax:412-366-0218
Practice Address - Street 1:4725 MCKNIGHT RD
Practice Address - Street 2:SUITE 222
Practice Address - City:PITTSBURGH
Practice Address - State:PA
Practice Address - Zip Code:15237-3414
Practice Address - Country:US
Practice Address - Phone:412-366-6990
Practice Address - Fax:412-366-0218
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-17
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PADS0364081223E0200X
PADS026828L1223E0200X
PADS030589L1223E0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223E0200XDental ProvidersDentistEndodonticsGroup - Single Specialty