| Edward J. Kolonsky Dmd Pc | |
|
27 W Washington St Shenandoah PA 17976-1708 | |
| (570) 462-4710 | |
| Not Available |
| Full Name | Edward J. Kolonsky Dmd Pc |
|---|---|
| Speciality | Dentist - General Practice |
| Location | 27 W Washington St, Shenandoah, Pennsylvania |
| Authorized Official Name and Position | Edward J Kolonsky (PRESIDENT/SECRETARY) |
| Authorized Official Contact | 5704624710 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Edward J. Kolonsky Dmd Pc 437 W Lloyd St Shenandoah PA 17976-1555 Ph: (570) 462-4710 | Edward J. Kolonsky Dmd Pc 27 W Washington St Shenandoah PA 17976-1708 Ph: (570) 462-4710 |
| NPI Number | 1720422009 |
|---|---|
| Provider Enumeration Date | 04/17/2013 |
| Last Update Date | 04/17/2013 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1720422009 | NPI | - | NPPES |
| 0011724020001 | Medicaid | PA |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223G0001X | Dentist - General Practice | DS026931L (Pennsylvania) | Primary |