Provider Demographics
NPI:1093783557
Name:OCHS, MARK WILSON (DMD)
Entity Type:Individual
Prefix:DR
First Name:MARK
Middle Name:WILSON
Last Name:OCHS
Suffix:
Gender:M
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3501 TERRACE STREET
Mailing Address - Street 2:SUITE 3189
Mailing Address - City:PITTSBURGH
Mailing Address - State:PA
Mailing Address - Zip Code:15261
Mailing Address - Country:US
Mailing Address - Phone:412-648-9100
Mailing Address - Fax:412-383-7862
Practice Address - Street 1:3501 TERRACE STREET
Practice Address - Street 2:SUITE 3189
Practice Address - City:PITTSBURGH
Practice Address - State:PA
Practice Address - Zip Code:15261
Practice Address - Country:US
Practice Address - Phone:412-648-9100
Practice Address - Fax:412-383-7862
Is Sole Proprietor?:No
Enumeration Date:2006-03-10
Last Update Date:2015-02-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PADS023398L1223S0112X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223S0112XDental ProvidersDentistOral and Maxillofacial Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA1284982Medicaid
PA1284982Medicaid
PA723384J18Medicare ID - Type Unspecified