Denise Olack, D.M.D.

Individual provider Active NPI General Practice Dentistry · Hunlock Creek, PA

NPI 1659547453 · NPPES record last updated May 1, 2008

Key facts

NPI
1659547453
Entity type
Individual (NPI type 1)
Primary specialty
General Practice Dentistry 1223G0001X
License
DS026824L (PA)
Practice address
46 Sweet Valley Rd
Hunlock Creek, PA 18621-3035
Phone
(570) 256-7346
Fax
(570) 256-7346
NPI assigned
May 1, 2008
Sex
Female
Sole proprietor
Yes

Medicare participation

Medicare fee-for-service enrollment
Enrolled in PA
Eligible to order & refer
Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: No · Hospice: Yes

Medicare enrollment records

Enrollment IDStateProvider typePAC IDDetails
I20151223000108 PA Order and Referring Only - Oral Surgery
Practitioner - Oral Surgery
5890096598

National Provider Directory

Medicare enrollment (NPD)
Yes

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X DS026824L PA Yes

Addresses

Primary practice location

46 Sweet Valley Rd
Hunlock Creek, PA 18621-3035

Mailing address

46 Sweet Valley Rd
Hunlock Creek, PA 18621-3035

Other providers in Hunlock Creek, PA

All providers in Hunlock Creek, PA · General Practice Dentistry in Pennsylvania

Sources for this page

Verify at the official NPI Registry.