Provider Demographics
NPI:1730682113
Name:COLLEEN R. CAIN, DMD, LLC
Entity type:Organization
Organization Name:COLLEEN R. CAIN, DMD, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/DENTIST
Authorized Official - Prefix:
Authorized Official - First Name:COLLEEN
Authorized Official - Middle Name:
Authorized Official - Last Name:CAIN
Authorized Official - Suffix:
Authorized Official - Credentials:DMD
Authorized Official - Phone:412-343-9999
Mailing Address - Street 1:3757 LIBRARY RD STE 100
Mailing Address - Street 2:
Mailing Address - City:PITTSBURGH
Mailing Address - State:PA
Mailing Address - Zip Code:15234-2267
Mailing Address - Country:US
Mailing Address - Phone:412-343-9999
Mailing Address - Fax:412-343-2939
Practice Address - Street 1:3757 LIBRARY RD STE 100
Practice Address - Street 2:
Practice Address - City:PITTSBURGH
Practice Address - State:PA
Practice Address - Zip Code:15234-2267
Practice Address - Country:US
Practice Address - Phone:412-343-9999
Practice Address - Fax:412-343-2939
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-03-13
Last Update Date:2018-03-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PADS038268261QD0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QD0000XAmbulatory Health Care FacilitiesClinic/CenterDental