Provider Demographics
NPI:1841209996
Name:LESNIAK, ROBERT E SR (DDS)
Entity Type:Individual
Prefix:DR
First Name:ROBERT
Middle Name:E
Last Name:LESNIAK
Suffix:SR
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 1:550 THIRD AVE.
Mailing Address - Street 2:SUITE 2
Mailing Address - City:KINGSTON
Mailing Address - State:PA
Mailing Address - Zip Code:18704-5806
Mailing Address - Country:US
Mailing Address - Phone:570-283-2800
Mailing Address - Fax:570-283-3381
Practice Address - Street 1:550 THIRD AVE.
Practice Address - Street 2:SUITE 2
Practice Address - City:KINGSTON
Practice Address - State:PA
Practice Address - Zip Code:18704-5806
Practice Address - Country:US
Practice Address - Phone:570-283-2800
Practice Address - Fax:570-283-3381
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-07
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PADS023788L1223E0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223E0200XDental ProvidersDentistEndodontics