Provider Demographics
NPI:1407018617
Name:PECHT, NATHAN A (DMD)
Entity type:Individual
Prefix:DR
First Name:NATHAN
Middle Name:A
Last Name:PECHT
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 1:115 S MOSHANNON AVE
Mailing Address - Street 2:APT A
Mailing Address - City:SNOW SHOE
Mailing Address - State:PA
Mailing Address - Zip Code:16874-8534
Mailing Address - Country:US
Mailing Address - Phone:814-387-6841
Mailing Address - Fax:814-387-3612
Practice Address - Street 1:115 S MOSHANNON AVE
Practice Address - Street 2:APT A
Practice Address - City:SNOW SHOE
Practice Address - State:PA
Practice Address - Zip Code:16874
Practice Address - Country:US
Practice Address - Phone:814-387-6841
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-06-28
Last Update Date:2012-09-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PADS037572122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist