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Individual

ISAAC NO

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man

Contact information

Practice address
5450 CAMPBELLS RUN RD, PITTSBURGH, PA 15205-1026
(412) 588-6600
Mailing address
3128 CHESTNUT RIDGE DR, PITTSBURGH, PA 15205-4731
(724) 701-0217

Taxonomy

Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
DS042256
PA

Other

Enumeration date
05/30/2019
Last updated
04/20/2024
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