Provider Demographics
NPI:1932761533
Name:KOLMAN, PAUL JONATHAN (DMD)
Entity Type:Individual
Prefix:DR
First Name:PAUL
Middle Name:JONATHAN
Last Name:KOLMAN
Suffix:
Gender:M
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1301 GLENBROOK RD
Mailing Address - Street 2:
Mailing Address - City:HUNTINGDON VALLEY
Mailing Address - State:PA
Mailing Address - Zip Code:19006-8322
Mailing Address - Country:US
Mailing Address - Phone:215-680-4588
Mailing Address - Fax:
Practice Address - Street 1:3915 W LINCOLN HWY
Practice Address - Street 2:
Practice Address - City:DOWNINGTOWN
Practice Address - State:PA
Practice Address - Zip Code:19335-5502
Practice Address - Country:US
Practice Address - Phone:610-269-1900
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-07-03
Last Update Date:2023-07-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PADS042298122300000X, 1223P0221X
OH30.026597122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223P0221XDental ProvidersDentistPediatric Dentistry
No122300000XDental ProvidersDentist