Provider Demographics
NPI:1245889740
Name:ORAL & FACIAL SURGERY OF PITTSBURGH, P.C.
Entity type:Organization
Organization Name:ORAL & FACIAL SURGERY OF PITTSBURGH, P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:KELLY
Authorized Official - Middle Name:
Authorized Official - Last Name:BAUER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:412-532-9720
Mailing Address - Street 1:180 SWINDERMAN RD STE 260
Mailing Address - Street 2:
Mailing Address - City:WEXFORD
Mailing Address - State:PA
Mailing Address - Zip Code:15090-5621
Mailing Address - Country:US
Mailing Address - Phone:412-532-9720
Mailing Address - Fax:412-532-9721
Practice Address - Street 1:180 SWINDERMAN RD STE 260
Practice Address - Street 2:
Practice Address - City:WEXFORD
Practice Address - State:PA
Practice Address - Zip Code:15090-5621
Practice Address - Country:US
Practice Address - Phone:412-532-9720
Practice Address - Fax:412-532-9721
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-09-06
Last Update Date:2023-02-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223S0112XDental ProvidersDentistOral and Maxillofacial SurgeryGroup - Single Specialty