Provider Demographics
NPI:1467566927
Name:CHERNOW, BRUCE A (DDS)
Entity Type:Individual
Prefix:DR
First Name:BRUCE
Middle Name:A
Last Name:CHERNOW
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 1:2100 N BROAD ST
Mailing Address - Street 2:SUITE 104
Mailing Address - City:LANSDALE
Mailing Address - State:PA
Mailing Address - Zip Code:19446-1052
Mailing Address - Country:US
Mailing Address - Phone:215-855-3233
Mailing Address - Fax:215-855-8029
Practice Address - Street 1:2100 N BROAD ST
Practice Address - Street 2:SUITE 104
Practice Address - City:LANSDALE
Practice Address - State:PA
Practice Address - Zip Code:19446-1052
Practice Address - Country:US
Practice Address - Phone:215-855-3233
Practice Address - Fax:215-855-8029
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-19
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PA1223P0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223P0700XDental ProvidersDentistProsthodontics