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General NPI Number Information
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NPI Number | 1124285929
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Entity Type | Organization
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Legal Business Name | JEFFREY M. PALUSAK DDS, INC
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Dates
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Enumeration Date | 05/20/2008
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Last Update Date | 03/13/2017
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Provider Practice Location Address
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Address Line | 155 DEAL DR
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City | COLUMBIANA
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State | OH
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Zip | 44408-8496
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Country | US
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Telephone | 330-482-3627
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Fax |
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Provider Business Mailing Address
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Address Line | 155 DEAL DR
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City | COLUMBIANA
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State | OH
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Zip | 44408-8496
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Country | US
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Telephone | 330-482-3627
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. JEFFREY MICHAEL PALUSAK
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Credential | DDS
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Telephone | 330-482-3627
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1223G0001X
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Taxonomy Name | General Practice Dentistry
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License Number | 30.020411
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License Number State | OH
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