Provider Demographics
NPI:1831158419
Name:A.L. CHECCHIO & G.T. DOWD, LTD.
Entity type:Organization
Organization Name:A.L. CHECCHIO & G.T. DOWD, LTD.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ORAL SURGEON
Authorized Official - Prefix:DR
Authorized Official - First Name:MARY ANNE
Authorized Official - Middle Name:
Authorized Official - Last Name:CHECCHIO
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:215-333-9696
Mailing Address - Street 1:9525 FRANKFORD AVENUE
Mailing Address - Street 2:
Mailing Address - City:PHILADELPHIA
Mailing Address - State:PA
Mailing Address - Zip Code:19114-2812
Mailing Address - Country:US
Mailing Address - Phone:215-333-9696
Mailing Address - Fax:215-333-8514
Practice Address - Street 1:9525 FRANKFORD AVE
Practice Address - Street 2:
Practice Address - City:PHILADELPHIA
Practice Address - State:PA
Practice Address - Zip Code:19114-2812
Practice Address - Country:US
Practice Address - Phone:215-333-9696
Practice Address - Fax:215-333-8514
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-03-21
Last Update Date:2012-02-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes204E00000XAllopathic & Osteopathic PhysiciansOral & Maxillofacial SurgeryGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA0060846000OtherKEYSTONE/PERSONAL CHOICE
PA30994OtherAETNA US HEALTHCARE
PA0060846000OtherKEYSTONE/PERSONAL CHOICE