# MICUCCI FAMILY DENTISTRY PC

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

## Provider details

- **NPI number:** 1598986416
- **Authorized official:** JOSEPH JAMES MICUCCI DMD (PRESIDENT)
- **Authorized official phone:** (412) 761-0202

## Contact information

- **Practice address:** 704 LINCOLN AVENUE, PITTSBURGH, PA 15202
- **Practice address phone:** (412) 761-0202
- **Practice address fax:** (412) 761-0732
- **Mailing address:** 704 LINCOLN AVENUE, PITTSBURGH, PA 15202
- **Mailing address phone:** (412) 761-0202
- **Mailing address fax:** (412) 761-0732

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 1223G0001X | General Practice Dentistry | DS026302L | PA | — |
| 1223G0001X | General Practice Dentistry | DS028123 | PA | Yes |

## Other

- **Enumeration date:** 05/01/2007
- **Last updated:** 08/22/2020

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 01 | — | 594774 | UNITED CONCORDIA DELTA DE | PA |