Kolodychak, Michael Thomas

Kolodychak, Michael Thomas is an individual health care provider with primary practice located at 4600 Zuck Rd , Erie PA 16506-4932. He recently has 2 registered licenses in different health care specialties including Dental Providers / Oral and Maxillofacial Surgery, Allopathic & Osteopathic Physicians / Oral & Maxillofacial Surgery. Allopathic & Osteopathic Physicians / Oral & Maxillofacial Surgery is his primary health care specialty. Kolodychak, Michael Thomas can be contacted via phone (814) 838-2144.

Contact Information

Primary practice address
4600 Zuck Rd Erie PA 16506-4932
Phone: (814) 838-2144
Fax: (814) 838-7227
Website:
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Health care specialties

SpecialtyCodeLicense #State
Dental Providers / Oral and Maxillofacial Surgery 1223S0112X DS029985L Pennsylvania
Allopathic & Osteopathic Physicians / Oral & Maxillofacial Surgery 204E00000X DS029985L Pennsylvania

Profile Details

NPI number 1376519181
LBN Legal business name Kolodychak, Michael Thomas
Credentials Doctor of Dental Medicine (DMD)
Entity Individual
Sole proprietor 1 No
Enumeration date Feb 23rd, 2006
Last updated Jun 21st, 2021 - about 3 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1376519181 NPPES
Pennsylvania Other DS029985L STATE LICENSE

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