Organization
412 DENTAL
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ELIJAH ED (DENTIST)
(412) 372-4214
Entity
Organization
Contact information
Practice address
2526 MONROEVILLE BLVD STE 209, MONROEVILLE, PA 15146-2358
(412) 372-2451
Mailing address
219 E END AVE # 1, PITTSBURGH, PA 15221-2727
(814) 525-8129
Taxonomy
Speciality
Code
Description
License number
State
261QD0000X
Dental Clinic/Center
Primary
DS040035
PA
Other
Enumeration date
06/29/2018
Last updated
06/29/2018
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