Provider Demographics
NPI:1437363108
Name:OLECHOWSKI, JOSEPH JOHN (DMD)
Entity Type:Individual
Prefix:DR
First Name:JOSEPH
Middle Name:JOHN
Last Name:OLECHOWSKI
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 1:12-15 BROADWAY
Mailing Address - Street 2:SUITE C
Mailing Address - City:FAIRLAWN
Mailing Address - State:NH
Mailing Address - Zip Code:07410
Mailing Address - Country:US
Mailing Address - Phone:201-797-2300
Mailing Address - Fax:201-797-8626
Practice Address - Street 1:12-15 BROADWAY
Practice Address - Street 2:SUITE C
Practice Address - City:FAIR LAWN
Practice Address - State:NJ
Practice Address - Zip Code:07410-2031
Practice Address - Country:US
Practice Address - Phone:201-797-2300
Practice Address - Fax:201-797-8626
Is Sole Proprietor?:No
Enumeration Date:2007-05-10
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJDI209201223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice