MEDICARE: DR. EDWARD AUGUST MUCHA D.D.S.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	1223G0001X	General Practice Dentistry	DS-022914-L	PA

General Provider Information

NPI Number	:	1346230281
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. EDWARD AUGUST MUCHA D.D.S.

Provider Business Mailing Address
First Line	:	223 EAST 8TH AVE.
Second Line	:
City	:	HOMESTEAD
State	:	PA
Zip	:	15120
Country	:	US
Telephone Number	:	412-461-1360
Fax Number	:	412-461-1360

Provider Business Practice Location Address
First Line	:	223 EAST 8TH AVE
Second Line	:
City	:	HOMESTEAD
State	:	PA
Zip	:	15120
Country	:	US
Telephone Number	:	412-461-1360
Fax Number	:	412-461-1360

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	10/23/2005
Last Update Date	:	12/28/2011

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