Provider Demographics
NPI:1396820510
Name:LAURENCE J OLOUGHLIN DMD PC
Entity Type:Organization
Organization Name:LAURENCE J OLOUGHLIN DMD PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:LAURENCE
Authorized Official - Middle Name:J
Authorized Official - Last Name:OLOUGHLIN
Authorized Official - Suffix:
Authorized Official - Credentials:DMD
Authorized Official - Phone:412-741-2262
Mailing Address - Street 1:432 CENTENNIAL AVENUE
Mailing Address - Street 2:
Mailing Address - City:SEWICKLEY
Mailing Address - State:PA
Mailing Address - Zip Code:15143-1504
Mailing Address - Country:US
Mailing Address - Phone:412-741-2262
Mailing Address - Fax:
Practice Address - Street 1:432 CENTENNIAL AVENUE
Practice Address - Street 2:
Practice Address - City:SEWICKLEY
Practice Address - State:PA
Practice Address - Zip Code:15143-1504
Practice Address - Country:US
Practice Address - Phone:412-741-2262
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-26
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PADS017183L122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Single Specialty