Provider Demographics
NPI:1215318993
Name:STEEL CITY DENTAL ASSOCIATES LLC
Entity type:Organization
Organization Name:STEEL CITY DENTAL ASSOCIATES LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:HEATHER
Authorized Official - Middle Name:
Authorized Official - Last Name:CIGRAND
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:412-824-6888
Mailing Address - Street 1:582 BROWN AVE
Mailing Address - Street 2:
Mailing Address - City:TURTLE CREEK
Mailing Address - State:PA
Mailing Address - Zip Code:15145-1318
Mailing Address - Country:US
Mailing Address - Phone:412-824-6888
Mailing Address - Fax:412-824-6886
Practice Address - Street 1:582 BROWN AVE
Practice Address - Street 2:
Practice Address - City:TURTLE CREEK
Practice Address - State:PA
Practice Address - Zip Code:15145-1318
Practice Address - Country:US
Practice Address - Phone:412-824-6888
Practice Address - Fax:412-824-6886
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-06-17
Last Update Date:2015-06-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PADS023683L122300000X
PADS040099122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA1025561210001Medicaid
PA102908672001Medicaid
PA1029297430002Medicaid