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General NPI Number Information
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NPI Number | 1477952430
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Entity Type | Organization
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Legal Business Name | ERIC OSMOLINSKI DMD INC
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Dates
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Enumeration Date | 08/15/2014
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Last Update Date | 08/15/2014
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Provider Practice Location Address
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Address Line | 9450 SCRANTON RD SUITE 109
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City | SAN DIEGO
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State | CA
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Zip | 92121-4720
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Country | US
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Telephone | 858-457-5801
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Fax | 858-457-8514
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Provider Business Mailing Address
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Address Line | 8450 SCRANTON ROAD SUITE 109
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City | SAN DIEGO
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State | CA
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Zip | 92121
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Country | US
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Telephone | 858-457-5801
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Fax | 858-457-8514
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Authorized Official
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Title or Position | OWNER
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Name | ERIC OSMOLINSKI
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Credential | DMD
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Telephone | 858-454-8485
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1223P0221X
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Taxonomy Name | Pediatric Dentistry
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License Number | 56739
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License Number State | CA
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Taxonomy #2
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Taxonomy Code | 1223S0112X
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Taxonomy Name | Oral and Maxillofacial Surgery (Dentist)
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License Number | 63159
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License Number State | CA
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