Individual
DR. JOLENE GAVLAK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
D.D.S.
Contact information
Practice address
109 N CENTRE ST, PHILIPSBURG, PA 16866-1661
(814) 342-1101
Mailing address
PO BOX 60, PHILIPSBURG, PA 16866-0060
(814) 342-1101
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
DS031452L
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0018194120003
—
PA
01
—
050047
UNITED CONCORDIA
PA
Enumeration date
03/20/2007
Last updated
02/23/2016
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