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General NPI Number Information
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NPI Number | 1487848693
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Entity Type | Organization
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Legal Business Name | TERRY D. OLEJKO, D.D.S., M.S.
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Dates
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Enumeration Date | 08/30/2007
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Last Update Date | 12/27/2007
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Provider Practice Location Address
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Address Line | 551 W CENTRAL AVE
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City | DELAWARE
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State | OH
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Zip | 43015-1493
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Country | US
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Telephone | 740-368-5566
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Fax | 740-368-5597
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Provider Business Mailing Address
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Address Line | 551 W CENTRAL AVE
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City | DELAWARE
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State | OH
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Zip | 43015-1493
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Country | US
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Telephone | 740-368-5566
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Fax | 740-368-5597
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Authorized Official
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Title or Position | OWNER
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Name | DR. TERRY DAVID OLEJKO
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Credential | D.D.S.
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Telephone | 740-368-5566
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1223S0112X
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Taxonomy Name | Oral and Maxillofacial Surgery (Dentist)
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License Number | 30-01-5199
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License Number State | OH
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