Provider Demographics
NPI:1346230281
Name:MUCHA, EDWARD AUGUST (DDS)
Entity Type:Individual
Prefix:DR
First Name:EDWARD
Middle Name:AUGUST
Last Name:MUCHA
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 1:223 EAST 8TH AVE.
Mailing Address - Street 2:
Mailing Address - City:HOMESTEAD
Mailing Address - State:PA
Mailing Address - Zip Code:15120
Mailing Address - Country:US
Mailing Address - Phone:412-461-1360
Mailing Address - Fax:412-461-1360
Practice Address - Street 1:223 EAST 8TH AVE
Practice Address - Street 2:
Practice Address - City:HOMESTEAD
Practice Address - State:PA
Practice Address - Zip Code:15120
Practice Address - Country:US
Practice Address - Phone:412-461-1360
Practice Address - Fax:412-461-1360
Is Sole Proprietor?:No
Enumeration Date:2005-10-23
Last Update Date:2011-12-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PADS-022914-L1223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice