Provider Demographics
NPI:1831107150
Name:GOLEMBIOSKI, RICHARD CARL JR (DMD)
Entity Type:Individual
Prefix:DR
First Name:RICHARD
Middle Name:CARL
Last Name:GOLEMBIOSKI
Suffix:JR
Gender:M
Credentials:DMD
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:5 ROUTE 94
Mailing Address - Street 2:SUITE A
Mailing Address - City:VERNON
Mailing Address - State:NJ
Mailing Address - Zip Code:07462-3805
Mailing Address - Country:US
Mailing Address - Phone:973-827-0234
Mailing Address - Fax:973-827-1105
Practice Address - Street 1:5 ROUTE 94
Practice Address - Street 2:SUITE A
Practice Address - City:VERNON
Practice Address - State:NJ
Practice Address - Zip Code:07462-3805
Practice Address - Country:US
Practice Address - Phone:973-827-0234
Practice Address - Fax:973-827-1105
Is Sole Proprietor?:No
Enumeration Date:2006-08-03
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJDI0015355122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist