# PINEO FAMILY DENTISTRY LLC

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

## Provider details

- **NPI number:** 1457360018
- **Authorized official:** DR. ROSS VICTOR PINEO DDS (OWNER)
- **Authorized official phone:** (814) 734-4451

## Contact information

- **Practice address:** 606 ERIE ST, EDINBORO, PA 16412-6002
- **Practice address phone:** (814) 734-4451
- **Practice address fax:** (814) 734-2863
- **Mailing address:** 606 ERIE ST, EDINBORO, PA 16412-6002
- **Mailing address phone:** (814) 734-4451
- **Mailing address fax:** (814) 734-2863

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 1223G0001X | General Practice Dentistry | DS035169 | PA | Yes |

## Other

- **Enumeration date:** 08/05/2006
- **Last updated:** 08/22/2020

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 1011637470001 | — | PA |
| 01 | — | 1384880 | BCBS | — |