Provider Demographics
NPI:1831107648
Name:PECHERSKY, JACK L (DMD)
Entity Type:Individual
Prefix:DR
First Name:JACK
Middle Name:L
Last Name:PECHERSKY
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 1:5518 POCUSSET ST
Mailing Address - Street 2:
Mailing Address - City:PITTSBURGH
Mailing Address - State:PA
Mailing Address - Zip Code:15217
Mailing Address - Country:US
Mailing Address - Phone:412-421-0629
Mailing Address - Fax:
Practice Address - Street 1:2345 MURRAY AVE
Practice Address - Street 2:SUITE 220
Practice Address - City:PITTSBURGH
Practice Address - State:PA
Practice Address - Zip Code:15217-2353
Practice Address - Country:US
Practice Address - Phone:412-422-1582
Practice Address - Fax:412-422-1583
Is Sole Proprietor?:No
Enumeration Date:2006-08-04
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PADS016789L1223P0221X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223P0221XDental ProvidersDentistPediatric Dentistry