Basic Information
| Provider Information | |||||||||
| NPI: | 1134240823 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | CHOMIAK | ||||||||
| FirstName: | JOSEPH | ||||||||
| MiddleName: | J | ||||||||
| NamePrefix: | DR. | ||||||||
| NameSuffix: | JR. | ||||||||
| Credential: | D.D.S. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 215 N PITTSBURGH ST | ||||||||
| Address2: | SUITE B | ||||||||
| City: | CONNELLSVILLE | ||||||||
| State: | PA | ||||||||
| PostalCode: | 154253209 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7246288110 | ||||||||
| FaxNumber: | 7246288802 | ||||||||
| Practice Location | |||||||||
| Address1: | 215 N PITTSBURGH ST | ||||||||
| Address2: | SUITE B | ||||||||
| City: | CONNELLSVILLE | ||||||||
| State: | PA | ||||||||
| PostalCode: | 154253209 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7246288110 | ||||||||
| FaxNumber: | 7246288802 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 04/02/2007 | ||||||||
| LastUpdateDate: | 07/08/2007 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 1223G0001X | DS-024244L | PA | Y | Dental Providers | Dentist | General Practice |
No ID Information.