Individual
JASON FOSTER LARUE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
2627 MURRAY AVE, PITTSBURGH, PA 15217-2418
(412) 422-5150
Mailing address
2627 MURRAY AVE, PITTSBURGH, PA 15217-2418
(412) 422-5150
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
DS037429
PA
1223G0001X
General Practice Dentistry
3765
WV
Other
Enumeration date
03/13/2008
Last updated
10/07/2021
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