Provider Demographics
NPI:1972718872
Name:ALLAN J. OLEINICK D.D.S P.C.
Entity Type:Organization
Organization Name:ALLAN J. OLEINICK D.D.S P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:ALLAN
Authorized Official - Middle Name:JEFFREY
Authorized Official - Last Name:OLEINICK
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:586-776-5945
Mailing Address - Street 1:25915 HARPER AVE
Mailing Address - Street 2:SUITE F
Mailing Address - City:SAINT CLAIR SHORES
Mailing Address - State:MI
Mailing Address - Zip Code:48081-3770
Mailing Address - Country:US
Mailing Address - Phone:586-776-5945
Mailing Address - Fax:586-776-5948
Practice Address - Street 1:25915 HARPER AVE
Practice Address - Street 2:SUITE F
Practice Address - City:SAINT CLAIR SHORES
Practice Address - State:MI
Practice Address - Zip Code:48081-3770
Practice Address - Country:US
Practice Address - Phone:586-776-5945
Practice Address - Fax:586-776-5948
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-14
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI29010135621223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty