| Organization Name: | WESTERN PENNSYLVANIA DENTAL GROUP |
| NPI Number: | 1417334335 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | ROBERT HUDOCK (PC PRESIDENT) |
| Mailing Address: | 1691 Route 228 Suite B Cranberry Township |
| State: | PA US |
| Postal Code: | 160665323 |
| Phone Number: | 7248634351 |
| Fax Number: | |
| NPI Enumeration Date: | 04/29/2015 |
| NPI Last Update Date: | 04/29/2015 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 261QD0000X |
| License Number: | DS029676 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | PA |
| Taxonomy Type: | Ambulatory Health Care Facilities |
| Taxonomy Classification: | Clinic/Center |
| Taxonomy Specialization: | Dental |
| Taxonomy Definition: | |