MEDICARE: CHENET COSMETIC AND FAMILY DENTISTRY P C

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	332BC3200X	Customized Equipment (DME)

General Provider Information

NPI Number	:	1710745153
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	CHENET COSMETIC AND FAMILY DENTISTRY P C

Provider Business Mailing Address
First Line	:	200 COMMERCE DR STE 203
Second Line	:
City	:	MOON TWP
State	:	PA
Zip	:	15108-3189
Country	:	US
Telephone Number	:	412-367-0367
Fax Number	:	412-367-0366

Provider Business Practice Location Address
First Line	:	20280 ROUTE 19 UNIT 6
Second Line	:
City	:	CRANBERRY TWP
State	:	PA
Zip	:	16066-6125
Country	:	US
Telephone Number	:	412-367-0367
Fax Number	:	412-367-0366

Authorized Official
Title or Position	:	PRESIDENT/OWNER
Name	:	DR. NICOLE D CHENET
Credential	:	DDS
Telephone Number	:	412-952-1939

Provider Enumeration Date	:	03/11/2024
Last Update Date	:	03/12/2024

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