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General NPI Number Information
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NPI Number | 1255540381
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Entity Type | Organization
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Legal Business Name | MARIA CHERNYAK DMD,INC
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Dates
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Enumeration Date | 05/22/2007
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Last Update Date | 10/06/2014
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Provider Practice Location Address
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Address Line | 10700 MONTGOMERY RD STE 220
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City | CINCINNATI
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State | OH
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Zip | 45242-3260
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Country | US
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Telephone | 513-793-8899
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Fax | 513-793-7713
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Provider Business Mailing Address
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Address Line | 10700 MONTGOMERY RD STE 220
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City | CINCINNATI
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State | OH
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Zip | 45242-3260
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Country | US
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Telephone | 513-793-8899
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Fax | 513-793-7713
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. MARIA CHERNYAK
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Credential | DMD
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Telephone | 513-793-8899
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QD0000X
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Taxonomy Name | Dental Clinic/Center
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License Number | 3020475
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License Number State | OH
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