1912963737 NPI number — SNYDER & DUGAN ORAL & MAXILLOFACIAL SURGERY P C

Table of content: (NPI 1912963737)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1912963737 NPI number — SNYDER & DUGAN ORAL & MAXILLOFACIAL SURGERY P C

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
SNYDER & DUGAN ORAL & MAXILLOFACIAL SURGERY P C
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1912963737
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
05/07/2012
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
9401 MCKNIGHT RD
Provider Second Line Business Mailing Address:
SUITE 201
Provider Business Mailing Address City Name:
PITTSBURGH
Provider Business Mailing Address State Name:
PA
Provider Business Mailing Address Postal Code:
15237-6000
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
412-366-2090
Provider Business Mailing Address Fax Number:
412-366-3477

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
9401 MCKNIGHT RD
Provider Second Line Business Practice Location Address:
SUITE 201
Provider Business Practice Location Address City Name:
PITTSBURGH
Provider Business Practice Location Address State Name:
PA
Provider Business Practice Location Address Postal Code:
15237-6000
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
412-366-2090
Provider Business Practice Location Address Fax Number:
412-366-3477
Provider Enumeration Date:
04/21/2006

Additional Information

			
		

Authorized Official

Authorized Official Last Name:
PERRY
Authorized Official First Name:
JOYCE
Authorized Official Middle Name:
Authorized Official Title or Position:
ACCOUNTS RECEIVABLE COORDINATOR
Authorized Official Telephone Number:
412-366-2090

Provider Taxonomy Codes

  • Taxonomy code: 1223S0112X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .
  • Taxonomy code: 207L00000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .

Other Provider's Identifiers (legacy, non-NPI)