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General NPI Number Information
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NPI Number | 1174799803
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Entity Type | Organization
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Legal Business Name | OLEYNIK, DMD, LLC
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Dates
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Enumeration Date | 05/02/2008
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Last Update Date | 02/12/2014
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Provider Practice Location Address
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Address Line | 74 WOOSTER ST
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City | SHELTON
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State | CT
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Zip | 06484-6055
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Country | US
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Telephone | 203-924-4731
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Fax | 203-924-0516
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Provider Business Mailing Address
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Address Line | 74 WOOSTER ST
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City | SHELTON
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State | CT
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Zip | 06484-6055
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Country | US
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Telephone | 203-924-4731
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Fax | 203-924-0516
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Authorized Official
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Title or Position | OWNER
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Name | DR. KENNETH F. OLEYNIK
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Credential | DMD
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Telephone | 203-924-4731
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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 | 6509
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License Number State | CT
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