Healthcare Provider Details

I. General information

NPI: 1932148061
Provider Name (Legal Business Name): RICHARD HOWARD MCNERNY DMD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/05/2006
Last Update Date: 08/09/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

31 N MAPLE AVE ORAL & MAXILLOFACIAL SURGERY, LTD.
GREENSBURG PA
15601-2503
US

IV. Provider business mailing address

31 N MAPLE AVE ORAL & MAXILLOFACIAL SURGERY, LTD.
GREENSBURG PA
15601-2503
US

V. Phone/Fax

Practice location:
  • Phone: 724-837-7770
  • Fax: 724-838-7731
Mailing address:
  • Phone: 724-837-7770
  • Fax: 724-838-7731

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223P0106X
TaxonomyOral and Maxillofacial Pathology Dentistry
License NumberDS018778L
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: