Provider Demographics
NPI:1003940610
Name:CHESTNUT DENTAL ASSOCIATES, PC
Entity Type:Organization
Organization Name:CHESTNUT DENTAL ASSOCIATES, PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:GENERAL DENTIST
Authorized Official - Prefix:DR
Authorized Official - First Name:CARL
Authorized Official - Middle Name:J
Authorized Official - Last Name:HORCHOS
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:610-384-2320
Mailing Address - Street 1:319 E CHESTNUT ST
Mailing Address - Street 2:
Mailing Address - City:COATESVILLE
Mailing Address - State:PA
Mailing Address - Zip Code:19320-3202
Mailing Address - Country:US
Mailing Address - Phone:610-384-2320
Mailing Address - Fax:610-384-7961
Practice Address - Street 1:319 E CHESTNUT ST
Practice Address - Street 2:
Practice Address - City:COATESVILLE
Practice Address - State:PA
Practice Address - Zip Code:19320-3202
Practice Address - Country:US
Practice Address - Phone:610-384-2320
Practice Address - Fax:610-384-7961
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-15
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PA027564122300000X
PA0275351223P0221X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Not Answered122300000XDental ProvidersDentistGroup - Multi-Specialty
Not Answered1223P0221XDental ProvidersDentistPediatric DentistryGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA1336167303OtherNPI PEDIATRIC DENTIST
PA1487676219OtherNPI GENERAL DENTIST