Provider Demographics
NPI:1447717251
Name:RIVERVUE DENTAL
Entity type:Organization
Organization Name:RIVERVUE DENTAL
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:GERRI
Authorized Official - Middle Name:
Authorized Official - Last Name:CLAIR
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:724-396-4894
Mailing Address - Street 1:504 ALLEGHENY RIVER BLVD
Mailing Address - Street 2:
Mailing Address - City:OAKMONT
Mailing Address - State:PA
Mailing Address - Zip Code:15139-1685
Mailing Address - Country:US
Mailing Address - Phone:412-828-2299
Mailing Address - Fax:
Practice Address - Street 1:504 ALLEGHENY RIVER BLVD
Practice Address - Street 2:
Practice Address - City:OAKMONT
Practice Address - State:PA
Practice Address - Zip Code:15139-1685
Practice Address - Country:US
Practice Address - Phone:412-828-2299
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-02-28
Last Update Date:2019-02-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QD0000XAmbulatory Health Care FacilitiesClinic/CenterDental