Organization
MICUCCI FAMILY DENTISTRY PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JOSEPH JAMES MICUCCI DMD (PRESIDENT)
(412) 761-0202
Entity
Organization
Contact information
Practice address
704 LINCOLN AVENUE, PITTSBURGH, PA 15202
(412) 761-0202
(412) 761-0732
Mailing address
704 LINCOLN AVENUE, PITTSBURGH, PA 15202
(412) 761-0202
(412) 761-0732
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
DS026302L
PA
1223G0001X
General Practice Dentistry
Primary
DS028123
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
594774
UNITED CONCORDIA DELTA DE
PA
Enumeration date
05/01/2007
Last updated
08/22/2020
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