Provider Demographics
NPI:1073614871
Name:MILLIGAN, WILBERT H III (DMD, PHD)
Entity Type:Individual
Prefix:DR
First Name:WILBERT
Middle Name:H
Last Name:MILLIGAN
Suffix:III
Gender:M
Credentials:DMD, PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2994 SUNSET CIR
Mailing Address - Street 2:
Mailing Address - City:EXPORT
Mailing Address - State:PA
Mailing Address - Zip Code:15632-9356
Mailing Address - Country:US
Mailing Address - Phone:724-325-3686
Mailing Address - Fax:
Practice Address - Street 1:UNIVERSITY OF PITTSBURGH SCHOOL OF DENTAL MEDICINE
Practice Address - Street 2:3501 TERRACE ST
Practice Address - City:PITTSBURGH
Practice Address - State:PA
Practice Address - Zip Code:15261-0001
Practice Address - Country:US
Practice Address - Phone:412-648-8570
Practice Address - Fax:412-648-8219
Is Sole Proprietor?:No
Enumeration Date:2006-09-26
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PADS021515L122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist
Provider Identifiers
StateIdentifier IDID TypeIssuer
PAMI163977OtherUNITED CONCORDIA
PA00000071854OtherDENTAL BENEFIT PROVIDERS
PA1009279640001Medicaid
PA000000176394Medicaid