Provider Demographics
NPI:1609821347
Name:GOLASZEWSKI, JANET ANN (DMD M ED)
Entity Type:Individual
Prefix:
First Name:JANET
Middle Name:ANN
Last Name:GOLASZEWSKI
Suffix:
Gender:F
Credentials:DMD M ED
Other - Prefix:MRS
Other - First Name:JANET
Other - Middle Name:ANN
Other - Last Name:MAZZOCCO
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:305 S CHURCH ST
Mailing Address - Street 2:STE 190 SOUTH GATE OFFICE COMPLEX
Mailing Address - City:HAZLETON
Mailing Address - State:PA
Mailing Address - Zip Code:18201-7605
Mailing Address - Country:US
Mailing Address - Phone:570-454-8601
Mailing Address - Fax:570-455-8369
Practice Address - Street 1:305 S CHURCH ST
Practice Address - Street 2:STE 190 SOUTH GATE OFFICE COMPLEX
Practice Address - City:HAZLETON
Practice Address - State:PA
Practice Address - Zip Code:18201-7605
Practice Address - Country:US
Practice Address - Phone:570-454-8601
Practice Address - Fax:570-455-8369
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-05-23
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PADS019709L1223X0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223X0400XDental ProvidersDentistOrthodontics and Dentofacial Orthopedics