Provider Demographics
NPI:1851651137
Name:MILUNSKY FAMILY DENTISTRY PC
Entity Type:Organization
Organization Name:MILUNSKY FAMILY DENTISTRY PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/DENTIST
Authorized Official - Prefix:DR
Authorized Official - First Name:JACOB
Authorized Official - Middle Name:ISRAEL
Authorized Official - Last Name:MILUNSKY
Authorized Official - Suffix:
Authorized Official - Credentials:DMD
Authorized Official - Phone:610-566-5322
Mailing Address - Street 1:214 STATE RD
Mailing Address - Street 2:
Mailing Address - City:MEDIA
Mailing Address - State:PA
Mailing Address - Zip Code:19063-1319
Mailing Address - Country:US
Mailing Address - Phone:610-566-5322
Mailing Address - Fax:610-566-5325
Practice Address - Street 1:214 STATE RD
Practice Address - Street 2:
Practice Address - City:MEDIA
Practice Address - State:PA
Practice Address - Zip Code:19063-1319
Practice Address - Country:US
Practice Address - Phone:610-566-5322
Practice Address - Fax:610-566-5325
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-05-21
Last Update Date:2012-05-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PADS0378131223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty