Organization
UPMC PRESBYTERIAN SHADYSIDE
Active
Other names
Braddock Dental Center of UPMC Presbyterian Shadyside
Organization subpart
No
Provider details
NPI number
Authorized official
MR. PAUL CASTILLO (CFO)
(412) 647-7713
Entity
Organization
Contact information
Practice address
818 BRADDOCK AVE, BRADDOCK, PA 15104-1715
(412) 636-5187
(412) 636-5248
Mailing address
818 BRADDOCK AVE, BRADDOCK, PA 15104-1715
(412) 636-5187
(412) 636-5248
Taxonomy
Speciality
Code
Description
License number
State
261QD0000X
Dental Clinic/Center
DS027386L
PA
261QD0000X
Dental Clinic/Center
DS030969L
PA
261QD0000X
Dental Clinic/Center
Primary
DS037519
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1007360690004
—
PA
Enumeration date
01/13/2010
Last updated
01/13/2010
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