Provider Demographics
NPI:1073634937
Name:CHARNESKY, DENNIS GEORGE (DDS)
Entity Type:Individual
Prefix:DR
First Name:DENNIS
Middle Name:GEORGE
Last Name:CHARNESKY
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4101 JOHN R ROAD SUITE 100
Mailing Address - Street 2:SUITE 100
Mailing Address - City:TROY
Mailing Address - State:MI
Mailing Address - Zip Code:48085
Mailing Address - Country:US
Mailing Address - Phone:248-680-0775
Mailing Address - Fax:248-680-1108
Practice Address - Street 1:4101 JOHN R RD STE 100
Practice Address - Street 2:SUITE 100
Practice Address - City:TROY
Practice Address - State:MI
Practice Address - Zip Code:48085-3647
Practice Address - Country:US
Practice Address - Phone:248-680-0775
Practice Address - Fax:248-680-1108
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-02
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI29010107841223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice