Provider Demographics
NPI:1659596724
Name:JAMIOLKOWSKI, THOMAS (DDS)
Entity Type:Individual
Prefix:DR
First Name:THOMAS
Middle Name:
Last Name:JAMIOLKOWSKI
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5N996 DUNHAM RD
Mailing Address - Street 2:
Mailing Address - City:WAYNE
Mailing Address - State:IL
Mailing Address - Zip Code:60184-2072
Mailing Address - Country:US
Mailing Address - Phone:630-788-8782
Mailing Address - Fax:
Practice Address - Street 1:455 S ROSELLE RD
Practice Address - Street 2:
Practice Address - City:SCHAUMBURG
Practice Address - State:IL
Practice Address - Zip Code:60193-2971
Practice Address - Country:US
Practice Address - Phone:847-352-5100
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-16
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL1223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice