Provider Demographics
NPI:1528193679
Name:CHARKAS, AHMED FAWAZ (DDS)
Entity Type:Individual
Prefix:DR
First Name:AHMED
Middle Name:FAWAZ
Last Name:CHARKAS
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 1:614 PETERSBURG RD
Mailing Address - Street 2:
Mailing Address - City:LANCASTER
Mailing Address - State:PA
Mailing Address - Zip Code:17601-8816
Mailing Address - Country:US
Mailing Address - Phone:904-345-9413
Mailing Address - Fax:
Practice Address - Street 1:207 N GUERNSEY RD
Practice Address - Street 2:
Practice Address - City:WEST GROVE
Practice Address - State:PA
Practice Address - Zip Code:19390-1028
Practice Address - Country:US
Practice Address - Phone:610-869-0991
Practice Address - Fax:610-869-0919
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-22
Last Update Date:2016-07-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PADS0382341223X0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223X0400XDental ProvidersDentistOrthodontics and Dentofacial Orthopedics