Provider First Line Business Practice Location Address:
2621 MAIN STREET
Provider Second Line Business Practice Location Address:
UNIVERSAL DENTAL BUILDING
Provider Business Practice Location Address City Name:
PITTSBURGH
Provider Business Practice Location Address State Name:
PA
Provider Business Practice Location Address Postal Code:
15235-3646
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
412-793-5520
Provider Business Practice Location Address Fax Number:
412-793-5360
Provider Enumeration Date:
12/26/2007