Provider Demographics
NPI:1801344023
Name:AZARBAL, ATOUSA (DMD, MDS)
Entity type:Individual
Prefix:DR
First Name:ATOUSA
Middle Name:
Last Name:AZARBAL
Suffix:
Gender:F
Credentials:DMD, MDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2078 SALK ANX
Mailing Address - Street 2:3501 TERRACE STREET
Mailing Address - City:PITTSBURGH
Mailing Address - State:PA
Mailing Address - Zip Code:15261-0001
Mailing Address - Country:US
Mailing Address - Phone:412-648-9687
Mailing Address - Fax:
Practice Address - Street 1:2078 SALK ANX
Practice Address - Street 2:3501 TERRACE STREET
Practice Address - City:PITTSBURGH
Practice Address - State:PA
Practice Address - Zip Code:15261-0001
Practice Address - Country:US
Practice Address - Phone:412-648-9687
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-09-16
Last Update Date:2016-09-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PADS0410331223P0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223P0700XDental ProvidersDentistProsthodontics