Provider Demographics
NPI:1245512243
Name:FOX CHAPEL CENTER FOR ADVANCED DENTAL CARE
Entity type:Organization
Organization Name:FOX CHAPEL CENTER FOR ADVANCED DENTAL CARE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DOCTOR
Authorized Official - Prefix:
Authorized Official - First Name:JAMES
Authorized Official - Middle Name:KEVIN
Authorized Official - Last Name:PAWLOWICZ
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:412-781-3030
Mailing Address - Street 1:1144 OLD FREEPORT RD
Mailing Address - Street 2:
Mailing Address - City:PITTSBURGH
Mailing Address - State:PA
Mailing Address - Zip Code:15238-3109
Mailing Address - Country:US
Mailing Address - Phone:412-781-3030
Mailing Address - Fax:412-781-3221
Practice Address - Street 1:1144 OLD FREEPORT RD
Practice Address - Street 2:
Practice Address - City:PITTSBURGH
Practice Address - State:PA
Practice Address - Zip Code:15238-3109
Practice Address - Country:US
Practice Address - Phone:412-781-3030
Practice Address - Fax:412-781-3221
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-09-15
Last Update Date:2011-09-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PADS028233L1223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty