Provider Demographics
NPI:1487147039
Name:THREE RIVERS ENDODONTICS EAST LLC
Entity type:Organization
Organization Name:THREE RIVERS ENDODONTICS EAST LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:MBR
Authorized Official - Prefix:DR
Authorized Official - First Name:ADAM
Authorized Official - Middle Name:
Authorized Official - Last Name:FEUER
Authorized Official - Suffix:
Authorized Official - Credentials:DMD
Authorized Official - Phone:412-776-0002
Mailing Address - Street 1:5770 BAUM BLVD STE 150
Mailing Address - Street 2:
Mailing Address - City:PITTSBURGH
Mailing Address - State:PA
Mailing Address - Zip Code:15206-3763
Mailing Address - Country:US
Mailing Address - Phone:412-776-0002
Mailing Address - Fax:
Practice Address - Street 1:5770 BAUM BLVD STE 150
Practice Address - Street 2:
Practice Address - City:PITTSBURGH
Practice Address - State:PA
Practice Address - Zip Code:15206-3763
Practice Address - Country:US
Practice Address - Phone:412-776-0002
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-06-08
Last Update Date:2018-06-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223E0200XDental ProvidersDentistEndodonticsGroup - Single Specialty