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General NPI Number Information
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NPI Number | 1760971345
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Entity Type | Organization
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Legal Business Name | SOUTH VUE DENTISTRY
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Dates
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Enumeration Date | 05/09/2018
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Last Update Date | 05/09/2018
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Provider Practice Location Address
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Address Line | 180 FORT COUCH RD STE 415
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City | PITTSBURGH
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State | PA
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Zip | 15241-1050
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Country | US
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Telephone | 412-835-2288
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Fax | 412-835-8054
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Provider Business Mailing Address
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Address Line | 180 FORT COUCH RD STE 415
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City | PITTSBURGH
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State | PA
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Zip | 15241-1050
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Country | US
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Telephone | 412-835-2288
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Fax | 412-835-8054
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Authorized Official
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Title or Position | DENTIST
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Name | DR. WESLEY HOWARD
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Credential | DDS
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Telephone | 412-835-2288
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QD0000X
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Taxonomy Name | Dental Clinic/Center
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License Number | DS039568
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License Number State | PA
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