Provider Demographics
NPI: | 1710745153 |
---|---|
Name: | CHENET COSMETIC AND FAMILY DENTISTRY P C |
Entity type: | Organization |
Organization Name: | CHENET COSMETIC AND FAMILY DENTISTRY P C |
Other - Org Name: | <UNAVAIL> |
Other - Org Type: | |
Authorized Official - Title/Position: | PRESIDENT/OWNER |
Authorized Official - Prefix: | DR |
Authorized Official - First Name: | NICOLE |
Authorized Official - Middle Name: | D |
Authorized Official - Last Name: | CHENET |
Authorized Official - Suffix: | |
Authorized Official - Credentials: | DDS |
Authorized Official - Phone: | 412-952-1939 |
Mailing Address - Street 1: | 200 COMMERCE DR STE 203 |
Mailing Address - Street 2: | |
Mailing Address - City: | MOON TWP |
Mailing Address - State: | PA |
Mailing Address - Zip Code: | 15108-3189 |
Mailing Address - Country: | US |
Mailing Address - Phone: | 412-367-0367 |
Mailing Address - Fax: | 412-367-0366 |
Practice Address - Street 1: | 20280 ROUTE 19 UNIT 6 |
Practice Address - Street 2: | |
Practice Address - City: | CRANBERRY TWP |
Practice Address - State: | PA |
Practice Address - Zip Code: | 16066-6125 |
Practice Address - Country: | US |
Practice Address - Phone: | 412-367-0367 |
Practice Address - Fax: | 412-367-0366 |
EIN: | <UNAVAIL> |
Is Organization Subpart?: | No |
Parent Organization LBN: | |
Parent Organization TIN: | |
Enumeration Date: | 2024-03-11 |
Last Update Date: | 2024-03-12 |
Deactivation Date: | |
Deactivation Code: | |
Reactivation Date: |
Provider Taxonomies
Primary? | Code | Type | Classification | Specialization |
---|---|---|---|---|
Yes | 332BC3200X | Suppliers | Durable Medical Equipment & Medical Supplies | Customized Equipment |