Provider Demographics
NPI:1891703864
Name:MECHELL, ANTHONY M JR (DMD)
Entity Type:Individual
Prefix:
First Name:ANTHONY
Middle Name:M
Last Name:MECHELL
Suffix:JR
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 1:600 ASHLAND AVE
Mailing Address - Street 2:
Mailing Address - City:SECANE
Mailing Address - State:PA
Mailing Address - Zip Code:19018
Mailing Address - Country:US
Mailing Address - Phone:610-534-9286
Mailing Address - Fax:
Practice Address - Street 1:600 ASHLAND AVE
Practice Address - Street 2:
Practice Address - City:SECANE
Practice Address - State:PA
Practice Address - Zip Code:19018
Practice Address - Country:US
Practice Address - Phone:610-534-9286
Practice Address - Fax:
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
PA05024650L122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist