# NORTHSIDE DENTAL

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

## Provider details

- **NPI number:** 1487155271
- **Authorized official:** DR. ADAM MYCHAK DMD (OWNER)
- **Authorized official phone:** (412) 366-7788

## Contact information

- **Practice address:** 814 CEDAR AVENUE, PITTSBURGH, PA 15212
- **Practice address phone:** (412) 366-7788
- **Mailing address:** 814 CEDAR AVE, PITTSBURGH, PA 15212-4812
- **Mailing address phone:** (412) 366-7788
- **Mailing address fax:** (412) 322-1087

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 1223G0001X | General Practice Dentistry | DS037298 | NULL | Yes |
| 1223G0001X | General Practice Dentistry | DS037298 | — | Yes |

## Other

- **Enumeration date:** 02/27/2018
- **Last updated:** 02/27/2018