Provider Demographics
NPI:1639298920
Name:BROCHETTI, CHERYL (RDH)
Entity type:Individual
Prefix:MRS
First Name:CHERYL
Middle Name:
Last Name:BROCHETTI
Suffix:
Gender:F
Credentials:RDH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:15141 US ROUTE 422
Mailing Address - Street 2:
Mailing Address - City:WORTHINGTON
Mailing Address - State:PA
Mailing Address - Zip Code:16262-2501
Mailing Address - Country:US
Mailing Address - Phone:724-297-3446
Mailing Address - Fax:724-297-3445
Practice Address - Street 1:15141 US ROUTE 422
Practice Address - Street 2:
Practice Address - City:WORTHINGTON
Practice Address - State:PA
Practice Address - Zip Code:16262-2501
Practice Address - Country:US
Practice Address - Phone:724-297-3446
Practice Address - Fax:724-297-3445
Is Sole Proprietor?:No
Enumeration Date:2007-03-28
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PADHO10318L124Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes124Q00000XDental ProvidersDental Hygienist