Provider Demographics
NPI:1932148061
Name:MCNERNY, RICHARD HOWARD (DMD)
Entity Type:Individual
Prefix:
First Name:RICHARD
Middle Name:HOWARD
Last Name:MCNERNY
Suffix:
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 1:31 N MAPLE AVE
Mailing Address - Street 2:ORAL & MAXILLOFACIAL SURGERY, LTD.
Mailing Address - City:GREENSBURG
Mailing Address - State:PA
Mailing Address - Zip Code:15601-2503
Mailing Address - Country:US
Mailing Address - Phone:724-837-7770
Mailing Address - Fax:724-838-7731
Practice Address - Street 1:31 N MAPLE AVE
Practice Address - Street 2:ORAL & MAXILLOFACIAL SURGERY, LTD.
Practice Address - City:GREENSBURG
Practice Address - State:PA
Practice Address - Zip Code:15601-2503
Practice Address - Country:US
Practice Address - Phone:724-837-7770
Practice Address - Fax:724-838-7731
Is Sole Proprietor?:No
Enumeration Date:2006-06-05
Last Update Date:2010-08-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PADS018778L1223P0106X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223P0106XDental ProvidersDentistOral and Maxillofacial Pathology
Provider Identifiers
StateIdentifier IDID TypeIssuer
PAMC038094Medicaid
PAT75602Medicare UPIN