Provider Demographics
NPI:1245980051
Name:POLISH CROWN DENTAL OF NATRONA HEIGHTS LLC
Entity type:Organization
Organization Name:POLISH CROWN DENTAL OF NATRONA HEIGHTS LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MS
Authorized Official - First Name:MARIA
Authorized Official - Middle Name:
Authorized Official - Last Name:COYLE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:412-224-7100
Mailing Address - Street 1:974 GREENTREE RD
Mailing Address - Street 2:
Mailing Address - City:PITTSBURGH
Mailing Address - State:PA
Mailing Address - Zip Code:15220-3304
Mailing Address - Country:US
Mailing Address - Phone:412-921-7575
Mailing Address - Fax:
Practice Address - Street 1:1629 UNION AVE
Practice Address - Street 2:
Practice Address - City:NATRONA HEIGHTS
Practice Address - State:PA
Practice Address - Zip Code:15065-2134
Practice Address - Country:US
Practice Address - Phone:724-224-7100
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:POLISH CROWN DENTAL LLC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2022-03-25
Last Update Date:2022-03-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QD0000XAmbulatory Health Care FacilitiesClinic/CenterDental