Provider Demographics
NPI:1053372706
Name:COYNE, SUZANNE (DMD)
Entity type:Individual
Prefix:DR
First Name:SUZANNE
Middle Name:
Last Name:COYNE
Suffix:
Gender:F
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9 HIGH RIDGE CT
Mailing Address - Street 2:
Mailing Address - City:NEW KENSINGTON
Mailing Address - State:PA
Mailing Address - Zip Code:15068-1771
Mailing Address - Country:US
Mailing Address - Phone:412-793-8043
Mailing Address - Fax:412-823-1729
Practice Address - Street 1:21 YOST BLVD
Practice Address - Street 2:SUITE 212
Practice Address - City:PITTSBURGH
Practice Address - State:PA
Practice Address - Zip Code:15221-5283
Practice Address - Country:US
Practice Address - Phone:412-829-0488
Practice Address - Fax:412-823-1729
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-03-31
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PADS027638L1223P0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223P0300XDental ProvidersDentistPeriodontics