Individual
DR. EDWARD J. KOLONSKY JR.
Active
Sole proprietor
Provider details
NPI number
Gender
Man
Credential
DMD
Contact information
Practice address
27 W WASHINGTON ST, SHENANDOAH, PA 17976-1708
(570) 462-4710
Mailing address
437 W LLOYD ST, SHENANDOAH, PA 17976-1555
(570) 462-2540
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
DS026931L
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0011724020001
—
PA
05
—
0011724020002
—
PA
Enumeration date
06/06/2006
Last updated
07/08/2007
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