Mark G Cherewka, DMD

Individual provider Active NPI General Practice Dentistry · Enola, PA

NPI 1275544975 · NPPES record last updated Nov 27, 2012

Key facts

NPI
1275544975
Entity type
Individual (NPI type 1)
Primary specialty
General Practice Dentistry 1223G0001X
License
DS-025505-L (PA)
Practice address
525 N Enola Rd
Enola, PA 17025-2129
Phone
(717) 732-2550
Fax
(717) 732-2275
NPI assigned
Aug 10, 2006
Sex
Male
Sole proprietor
Yes

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No

State licenses

LicenseStateTypeSpecialty
DS-025505-LPAMDGeneral Practice Dentistry

Practice roles

OrganizationSpecialtyStatusNew patients
Ti-Consulting General Practice Past Accepting new patients

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X DS-025505-L PA Yes

Addresses

Primary practice location

525 N Enola Rd
Enola, PA 17025-2129

Mailing address

525 N Enola Rd
Enola, PA 17025-2129
Phone (717) 732-2550

Other providers in Enola, PA

All providers in Enola, PA · General Practice Dentistry in Pennsylvania

Sources for this page

Verify at the official NPI Registry.