Individual
ANEL BASIC
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DMD
Contact information
Practice address
320 E NORTH AVE, PITTSBURGH, PA 15212-4772
(216) 368-3200
Mailing address
320 E NORTH AVE, SUITE 6100, SOUTH TOWER, PITTSBURGH, PA 15212-4772
(412) 359-3988
(412) 359-3266
Taxonomy
Speciality
Code
Description
License number
State
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
Primary
30.026595
OH
Other
Enumeration date
08/04/2021
Last updated
02/01/2023
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