Provider Demographics
NPI:1689001794
Name:OSKOWIAK, KENNETH J (DMD)
Entity Type:Individual
Prefix:DR
First Name:KENNETH
Middle Name:J
Last Name:OSKOWIAK
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 1:19 E EVESHAM RD
Mailing Address - Street 2:
Mailing Address - City:VOORHEES
Mailing Address - State:NJ
Mailing Address - Zip Code:08043-1168
Mailing Address - Country:US
Mailing Address - Phone:856-428-1598
Mailing Address - Fax:856-428-1305
Practice Address - Street 1:19 E EVESHAM RD
Practice Address - Street 2:
Practice Address - City:VOORHEES
Practice Address - State:NJ
Practice Address - Zip Code:08043-1168
Practice Address - Country:US
Practice Address - Phone:856-428-1598
Practice Address - Fax:856-428-1305
Is Sole Proprietor?:No
Enumeration Date:2013-10-03
Last Update Date:2013-10-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ22DI017472001223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice