Provider Demographics
NPI:1760971345
Name:SOUTH VUE DENTISTRY
Entity Type:Organization
Organization Name:SOUTH VUE DENTISTRY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DENTIST
Authorized Official - Prefix:DR
Authorized Official - First Name:WESLEY
Authorized Official - Middle Name:
Authorized Official - Last Name:HOWARD
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:412-835-2288
Mailing Address - Street 1:180 FORT COUCH RD STE 415
Mailing Address - Street 2:
Mailing Address - City:PITTSBURGH
Mailing Address - State:PA
Mailing Address - Zip Code:15241-1050
Mailing Address - Country:US
Mailing Address - Phone:412-835-2288
Mailing Address - Fax:412-835-8054
Practice Address - Street 1:180 FORT COUCH RD STE 415
Practice Address - Street 2:
Practice Address - City:PITTSBURGH
Practice Address - State:PA
Practice Address - Zip Code:15241-1050
Practice Address - Country:US
Practice Address - Phone:412-835-2288
Practice Address - Fax:412-835-8054
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-05-09
Last Update Date:2018-05-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PADS039568261QD0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QD0000XAmbulatory Health Care FacilitiesClinic/CenterDental