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General NPI Number Information
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NPI Number | 1528100039
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Entity Type | Organization
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Legal Business Name | DR M CHENNAT & ASSOCIATES
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Dates
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Enumeration Date | 02/12/2007
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Last Update Date | 07/23/2008
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Provider Practice Location Address
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Address Line | 8227 STENTON AVE
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City | PHILADELPHIA
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State | PA
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Zip | 19150
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Country | US
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Telephone | 215-248-5950
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Fax |
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Provider Business Mailing Address
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Address Line | 500 PRESTON COURT
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City | EXTON
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State | PA
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Zip | 19341
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Country | US
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Telephone | 610-594-1870
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | MARIAMMA T CHENNAT
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Credential | DMD
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Telephone | 215-248-5950
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1223G0001X
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Taxonomy Name | General Practice Dentistry
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License Number | DS019459L
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License Number State | PA
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