Provider Demographics
NPI:1255404182
Name:OSMOLINKSKI, GERALD ALBERT (DDS)
Entity type:Individual
Prefix:
First Name:GERALD
Middle Name:ALBERT
Last Name:OSMOLINKSKI
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 1:1015 S 13TH ST
Mailing Address - Street 2:
Mailing Address - City:ALTOONA
Mailing Address - State:PA
Mailing Address - Zip Code:16602-6013
Mailing Address - Country:US
Mailing Address - Phone:814-944-4907
Mailing Address - Fax:
Practice Address - Street 1:1015 S 13TH ST
Practice Address - Street 2:
Practice Address - City:ALTOONA
Practice Address - State:PA
Practice Address - Zip Code:16602-6013
Practice Address - Country:US
Practice Address - Phone:814-944-4907
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-11-16
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PA05018614L122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist