# THE DENTISTS AT SHADYSIDE PLACE, LLC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1417336819
- **Authorized official:** DR. BOBBIE LEE HAWRANKO D.M.D. (PRESIDENT)
- **Authorized official phone:** (412) 622-0221

## Contact information

- **Practice address:** 580 S AIKEN AVE, SUITE 620, PITTSBURGH, PA 15232-1531
- **Practice address phone:** (412) 622-0221
- **Practice address fax:** (412) 622-0224
- **Mailing address:** 580 S AIKEN AVE, SUITE 620, PITTSBURGH, PA 15232-1531
- **Mailing address phone:** (412) 622-0221
- **Mailing address fax:** (412) 622-0224

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 122300000X | Dentist | — | NULL | Yes |
| 122300000X | Dentist | — | — | Yes |

## Other

- **Enumeration date:** 05/19/2015
- **Last updated:** 05/19/2015