Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 1223S0112X | Oral and Maxillofacial Surgeon | 30-024004 | OH |
N | 1223S0112X | Oral and Maxillofacial Surgeon | DS031233 | PA |
N | 204E00000X | Oral & Maxillofacial Surgeon | DN000685 | PA |
NPI | 1437280583 |
---|---|
Provider Name | Andres Pinto |
First Address | Cleveland, OH 44109-1900 |
Second Address | Cleveland, OH 44109-1900 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 08/03/2007 |
Last Update Date | 27/12/2021 |