Provider Demographics
NPI:1215003389
Name:KENNETH J. OSKOWIAK & ASSOCIATES, DMD,PC
Entity Type:Organization
Organization Name:KENNETH J. OSKOWIAK & ASSOCIATES, DMD,PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:KENNETH
Authorized Official - Middle Name:J
Authorized Official - Last Name:OSKOWIAK
Authorized Official - Suffix:
Authorized Official - Credentials:DMD
Authorized Official - Phone:856-428-1598
Mailing Address - Street 1:19 E EVESHAM RD
Mailing Address - Street 2:
Mailing Address - City:VOORHEES
Mailing Address - State:NJ
Mailing Address - Zip Code:08043-1168
Mailing Address - Country:US
Mailing Address - Phone:856-428-1598
Mailing Address - Fax:856-428-1305
Practice Address - Street 1:19 E EVESHAM RD
Practice Address - Street 2:
Practice Address - City:VOORHEES
Practice Address - State:NJ
Practice Address - Zip Code:08043-1168
Practice Address - Country:US
Practice Address - Phone:856-428-1598
Practice Address - Fax:856-428-1305
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-11-28
Last Update Date:2013-10-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ22DI017472001223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty