Provider Demographics
NPI:1841343183
Name:KACHUR, ELENA (DMD)
Entity type:Individual
Prefix:
First Name:ELENA
Middle Name:
Last Name:KACHUR
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 1:1000 GERMANTOWN PIKE STE F4
Mailing Address - Street 2:PLYMOUTH GREENE OFFICE CAMPUS
Mailing Address - City:PLYMOUTH MEETING
Mailing Address - State:PA
Mailing Address - Zip Code:19462-2486
Mailing Address - Country:US
Mailing Address - Phone:610-278-6500
Mailing Address - Fax:610-278-6501
Practice Address - Street 1:1000 GERMANTOWN PIKE STE F4
Practice Address - Street 2:PLYMOUTH GREENE OFFICE CAMPUS
Practice Address - City:PLYMOUTH MEETING
Practice Address - State:PA
Practice Address - Zip Code:19462-2486
Practice Address - Country:US
Practice Address - Phone:610-278-6500
Practice Address - Fax:610-278-6501
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-19
Last Update Date:2008-04-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PA0306001223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice