| Vivid Dental Pllc | |
|
4290 William Flynn Hwy Ste 202 Allison Park PA 15101-1443 | |
| (412) 213-0075 | |
| Not Available |
| Full Name | Vivid Dental Pllc |
|---|---|
| Speciality | Dentist |
| Location | 4290 William Flynn Hwy Ste 202, Allison Park, Pennsylvania |
| Authorized Official Name and Position | Megan Ross (PRESIDENT) |
| Authorized Official Contact | 4129290254 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Vivid Dental Pllc Po Box 16008 Pittsburgh PA 15242-0008 Ph: (412) 929-0254 | Vivid Dental Pllc 4290 William Flynn Hwy Ste 202 Allison Park PA 15101-1443 Ph: (412) 213-0075 |
| NPI Number | 1275240244 |
|---|---|
| Provider Enumeration Date | 10/31/2022 |
| Last Update Date | 10/31/2022 |
| Medicare PECOS PAC ID | 8022480128 |
|---|---|
| Medicare Enrollment ID | O20230220001213 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1275240244 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 122300000X | Dentist | (* (Not Available)) | Primary |
| Provider Name | Megan Cafferty Ross |
|---|---|
| Provider Type | Practitioner - Dentist |
| Provider Identifiers | NPI Number: 1568922714 PECOS PAC ID: 9931571031 Enrollment ID: I20230220001319 |
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