Provider Demographics
NPI:1396965497
Name:DZUBAN, DAVID PAUL (DDS)
Entity type:Individual
Prefix:DR
First Name:DAVID
Middle Name:PAUL
Last Name:DZUBAN
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:300 PENN CENTER BLVD STE 210
Mailing Address - Street 2:
Mailing Address - City:PITTSBURGH
Mailing Address - State:PA
Mailing Address - Zip Code:15235-5502
Mailing Address - Country:US
Mailing Address - Phone:412-367-3368
Mailing Address - Fax:412-367-0451
Practice Address - Street 1:300 PENN CENTER BLVD STE 210
Practice Address - Street 2:
Practice Address - City:PITTSBURGH
Practice Address - State:PA
Practice Address - Zip Code:15235-5502
Practice Address - Country:US
Practice Address - Phone:412-367-3368
Practice Address - Fax:412-367-0451
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-30
Last Update Date:2018-11-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PADS028795L332B00000X, 122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist
No332B00000XSuppliersDurable Medical Equipment & Medical Supplies