Provider Demographics
NPI:1790161370
Name:COMPREHENSIVE FAMILY AND COSMETIC DENTAL CENTER
Entity Type:Organization
Organization Name:COMPREHENSIVE FAMILY AND COSMETIC DENTAL CENTER
Other - Org Name:HENRY J. ZIELINSKI, JR., D.D.S.
Other - Org Type:Other Name
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:HENRY
Authorized Official - Middle Name:J
Authorized Official - Last Name:ZIELINSKI
Authorized Official - Suffix:JR
Authorized Official - Credentials:DDS
Authorized Official - Phone:570-288-3697
Mailing Address - Street 1:450 WARREN AVE
Mailing Address - Street 2:
Mailing Address - City:KINGSTON
Mailing Address - State:PA
Mailing Address - Zip Code:18704-5235
Mailing Address - Country:US
Mailing Address - Phone:570-288-3697
Mailing Address - Fax:570-288-7723
Practice Address - Street 1:450 WARREN AVE
Practice Address - Street 2:
Practice Address - City:KINGSTON
Practice Address - State:PA
Practice Address - Zip Code:18704-5235
Practice Address - Country:US
Practice Address - Phone:570-288-3697
Practice Address - Fax:570-288-7723
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-08-05
Last Update Date:2015-08-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PADS018307305S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes305S00000XManaged Care OrganizationsPoint of Service