Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 1223D0001X | Dental Public Health | DS025169L | PA |
NPI | 1477721512 |
---|---|
Provider Name | Dr. Dino Robert Angelici |
First Address | Bethel Park, PA 15102-1963 |
Second Address | Bethel Park, PA 15102-1963 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 12/02/2008 |
Last Update Date | 12/02/2008 |