Provider Demographics
NPI:1346457520
Name:GERMANOSKI, BRIAN (DMD)
Entity Type:Individual
Prefix:
First Name:BRIAN
Middle Name:
Last Name:GERMANOSKI
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 1:435 MAIN STREET
Mailing Address - Street 2:PO BOX 868
Mailing Address - City:SAEGERTOWN
Mailing Address - State:PA
Mailing Address - Zip Code:16433
Mailing Address - Country:US
Mailing Address - Phone:814-763-4811
Mailing Address - Fax:
Practice Address - Street 1:435 MAIN STREET
Practice Address - Street 2:
Practice Address - City:SAEGERTOWN
Practice Address - State:PA
Practice Address - Zip Code:16433
Practice Address - Country:US
Practice Address - Phone:814-763-4811
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-05-17
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PADS0351231223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice