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General NPI Number Information
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NPI Number | 1720833882
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Entity Type | Organization
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Legal Business Name | JEFFREY L. GOLOMBISKY
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Dates
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Enumeration Date | 04/22/2024
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Last Update Date | 04/10/2025
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Provider Practice Location Address
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Address Line | 1336 E M 21
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City | OWOSSO
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State | MI
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Zip | 48867-9039
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Country | US
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Telephone | 989-723-8135
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Fax | 989-723-8649
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Provider Business Mailing Address
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Address Line | 1336 E M 21
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City | OWOSSO
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State | MI
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Zip | 48867-9039
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Country | US
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Telephone | 989-723-8135
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Fax | 989-723-8649
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Authorized Official
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Title or Position | INSURANCE SPECIALIST
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Name | ANDREA BALMA
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Credential |
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Telephone | 989-723-8135
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QD0000X
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Taxonomy Name | Dental Clinic/Center
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License Number |
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License Number State |
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