Provider Demographics
NPI:1942090907
Name:PETRARCA, ALLISON JEAN (DMD)
Entity type:Individual
Prefix:
First Name:ALLISON
Middle Name:JEAN
Last Name:PETRARCA
Suffix:
Gender:F
Credentials:DMD
Other - Prefix:
Other - First Name:ALLISON
Other - Middle Name:JEAN
Other - Last Name:PAVLAN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:DMD
Mailing Address - Street 1:5797 MADISON AVE
Mailing Address - Street 2:
Mailing Address - City:EXPORT
Mailing Address - State:PA
Mailing Address - Zip Code:15632-1318
Mailing Address - Country:US
Mailing Address - Phone:412-607-8105
Mailing Address - Fax:
Practice Address - Street 1:1789 S BRADDOCK AVE STE 410
Practice Address - Street 2:
Practice Address - City:PITTSBURGH
Practice Address - State:PA
Practice Address - Zip Code:15218-1881
Practice Address - Country:US
Practice Address - Phone:412-247-2310
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-05-12
Last Update Date:2025-06-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PADS0451281223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice