Provider Demographics
NPI:1336875681
Name:PITTSBURGH DENTAL SLEEP MEDICINE, INC.
Entity Type:Organization
Organization Name:PITTSBURGH DENTAL SLEEP MEDICINE, INC.
Other - Org Name:PENNSYLVANIA DENTAL SLEEP MEDICINE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRACTICE MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:CARLY
Authorized Official - Middle Name:
Authorized Official - Last Name:MUNDIE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:724-935-6670
Mailing Address - Street 1:11676 PERRY HWY STE 3201
Mailing Address - Street 2:
Mailing Address - City:WEXFORD
Mailing Address - State:PA
Mailing Address - Zip Code:15090-7204
Mailing Address - Country:US
Mailing Address - Phone:724-935-6670
Mailing Address - Fax:724-935-6758
Practice Address - Street 1:4813 JONESTOWN RD STE 104
Practice Address - Street 2:
Practice Address - City:HARRISBURG
Practice Address - State:PA
Practice Address - Zip Code:17109-1700
Practice Address - Country:US
Practice Address - Phone:717-995-3590
Practice Address - Fax:717-995-3591
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-07-28
Last Update Date:2023-10-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
No332BC3200XSuppliersDurable Medical Equipment & Medical SuppliesCustomized Equipment