Provider Demographics
NPI:1932139524
Name:OSOFSKY, STUART W (DDS)
Entity Type:Individual
Prefix:DR
First Name:STUART
Middle Name:W
Last Name:OSOFSKY
Suffix:
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 1:888 27TH ST
Mailing Address - Street 2:
Mailing Address - City:OGDEN
Mailing Address - State:UT
Mailing Address - Zip Code:84403-0204
Mailing Address - Country:US
Mailing Address - Phone:801-393-8814
Mailing Address - Fax:801-399-1578
Practice Address - Street 1:888 27TH ST
Practice Address - Street 2:
Practice Address - City:OGDEN
Practice Address - State:UT
Practice Address - Zip Code:84403-0204
Practice Address - Country:US
Practice Address - Phone:801-393-8814
Practice Address - Fax:801-399-1578
Is Sole Proprietor?:No
Enumeration Date:2006-07-03
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT29289499221223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice