# THREE RIVERS DENTAL GROUP/UPPER ST. CLAIR/LLC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1427587047
- **Authorized official:** MS. LORI A MILLIRON (EXECUTIVE ADMINISTRATOR)
- **Authorized official phone:** (724) 978-1010

## Contact information

- **Practice address:** 86 FORT COUCH RD, PITTSBURGH, PA 15241-1020
- **Practice address phone:** (412) 833-9540
- **Practice address fax:** (412) 833-4525
- **Mailing address:** 86 FORT COUCH RD, PITTSBURGH, PA 15241-1020
- **Mailing address phone:** (412) 833-9540
- **Mailing address fax:** (412) 833-9546

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 122300000X | Dentist | DS021586L | PA | Yes |
| 1223P0700X | Prosthodontics | DS017612L | PA | — |

## Other

- **Enumeration date:** 06/07/2017
- **Last updated:** 06/07/2017