Provider Demographics
NPI:1962683953
Name:PASTERNACK, CHARA (DMD)
Entity Type:Individual
Prefix:DR
First Name:CHARA
Middle Name:
Last Name:PASTERNACK
Suffix:
Gender:F
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1 BRITTON PL
Mailing Address - Street 2:SUITE 11
Mailing Address - City:VOORHEES
Mailing Address - State:NJ
Mailing Address - Zip Code:08043-2514
Mailing Address - Country:US
Mailing Address - Phone:856-770-0033
Mailing Address - Fax:
Practice Address - Street 1:1 BRITTON PL
Practice Address - Street 2:SUITE 11
Practice Address - City:VOORHEES
Practice Address - State:NJ
Practice Address - Zip Code:08043-2514
Practice Address - Country:US
Practice Address - Phone:856-770-0033
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-11-18
Last Update Date:2007-11-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ22DI023446001223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice