Provider Demographics
NPI:1477952430
Name:ERIC OSMOLINSKI DMD INC
Entity Type:Organization
Organization Name:ERIC OSMOLINSKI DMD INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:ERIC
Authorized Official - Middle Name:
Authorized Official - Last Name:OSMOLINSKI
Authorized Official - Suffix:
Authorized Official - Credentials:DMD
Authorized Official - Phone:858-454-8485
Mailing Address - Street 1:8450 SCRANTON ROAD
Mailing Address - Street 2:SUITE 109
Mailing Address - City:SAN DIEGO
Mailing Address - State:CA
Mailing Address - Zip Code:92121
Mailing Address - Country:US
Mailing Address - Phone:858-457-5801
Mailing Address - Fax:858-457-8514
Practice Address - Street 1:9450 SCRANTON RD
Practice Address - Street 2:SUITE 109
Practice Address - City:SAN DIEGO
Practice Address - State:CA
Practice Address - Zip Code:92121-4720
Practice Address - Country:US
Practice Address - Phone:858-457-5801
Practice Address - Fax:858-457-8514
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-08-15
Last Update Date:2014-08-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA567391223P0221X
CA631591223S0112X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223S0112XDental ProvidersDentistOral and Maxillofacial SurgeryGroup - Multi-Specialty
No1223P0221XDental ProvidersDentistPediatric DentistryGroup - Multi-Specialty