Provider Demographics
NPI:1477654150
Name:DOLOBACH, BERNARD JOSEPH (DMD)
Entity Type:Individual
Prefix:DR
First Name:BERNARD
Middle Name:JOSEPH
Last Name:DOLOBACH
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 1:416 MARKET STREET
Mailing Address - Street 2:
Mailing Address - City:BROWNSVILLE
Mailing Address - State:PA
Mailing Address - Zip Code:15417
Mailing Address - Country:US
Mailing Address - Phone:724-785-8194
Mailing Address - Fax:
Practice Address - Street 1:416 MARKET STREET
Practice Address - Street 2:
Practice Address - City:BROWNSVILLE
Practice Address - State:PA
Practice Address - Zip Code:15417
Practice Address - Country:US
Practice Address - Phone:724-785-8194
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-09-26
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PADS020834L122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist