Individual
MATILDA DHIMA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DMD, MS
Contact information
Practice address
3501 TERRACE ST, SUITE 3189, PITTSBURGH, PA 15213-2523
(412) 648-9100
Mailing address
3501 TERRACE ST, SUITE 3189, PITTSBURGH, PA 15213-2523
Taxonomy
Speciality
Code
Description
License number
State
1223P0700X
Prosthodontics
Primary
DS039457
PA
204E00000X
Oral & Maxillofacial Surgery (D.M.D.)
D12734
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
ENROLLED
—
MN
01
—
P00863973
MEDICARE - RAIL ROAD
MN
Enumeration date
07/01/2009
Last updated
07/03/2013
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