1003062910 NPI number — MARYANN DAVIS, DMD & ASSOCIATES, LLC.

Table of content: (NPI 1003062910)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1003062910 NPI number — MARYANN DAVIS, DMD & ASSOCIATES, LLC.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
MARYANN DAVIS, DMD & ASSOCIATES, LLC.
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:
1003062910
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
09/21/2011
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
329 SADDLE BROOK ROAD
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
GIBSONIA
Provider Business Mailing Address State Name:
PA
Provider Business Mailing Address Postal Code:
15044-7809
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
724-444-0620
Provider Business Mailing Address Fax Number:
724-444-0620

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
3808 BRIGHTON ROAD
Provider Second Line Business Practice Location Address:
SUITE 1
Provider Business Practice Location Address City Name:
PITTSBURGH
Provider Business Practice Location Address State Name:
PA
Provider Business Practice Location Address Postal Code:
15212-1677
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
412-766-3100
Provider Business Practice Location Address Fax Number:
412-766-3100
Provider Enumeration Date:
08/12/2008

Additional Information

Authorized Official

Authorized Official Last Name:
DAVIS
Authorized Official First Name:
MARY
Authorized Official Middle Name:
ANN
Authorized Official Title or Position:
OWNER - DENTIST
Authorized Official Telephone Number:
412-766-3100

Provider Taxonomy Codes

  • Taxonomy code: 122300000X , with the licence number:  DS020711L , registered in the state of PA ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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





Copyright © 2007-2025 www.npivalidator.com