Provider Demographics
NPI:1710146469
Name:MARCHACK, CHRISTOPHER BRIAN (DDS)
Entity Type:Individual
Prefix:
First Name:CHRISTOPHER
Middle Name:BRIAN
Last Name:MARCHACK
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 1:301 S FAIR OAKS AVE
Mailing Address - Street 2:SUITE 408
Mailing Address - City:PASADENA
Mailing Address - State:CA
Mailing Address - Zip Code:91105-2561
Mailing Address - Country:US
Mailing Address - Phone:626-793-6700
Mailing Address - Fax:626-793-8777
Practice Address - Street 1:301 S FAIR OAKS AVE
Practice Address - Street 2:SUITE 408
Practice Address - City:PASADENA
Practice Address - State:CA
Practice Address - Zip Code:91105-2561
Practice Address - Country:US
Practice Address - Phone:626-793-6700
Practice Address - Fax:626-793-8777
Is Sole Proprietor?:No
Enumeration Date:2008-06-07
Last Update Date:2008-06-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA357581223P0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223P0700XDental ProvidersDentistProsthodontics