Kolasa, Justin R

Kolasa, Justin R is an individual health care provider with primary practice located at 400 S 4Th St , Danville KY 40422-2094. He recently has 3 registered licenses in different health care specialties including Other Service Providers / Specialist, Student, Health Care / Student in an Organized Health Care Education/Training Program, Dental Providers / Oral and Maxillofacial Surgery. Dental Providers / Oral and Maxillofacial Surgery is his primary health care specialty. Kolasa, Justin R can be contacted via phone (859) 236-1130.

Contact Information

Primary practice address
400 S 4Th St Danville KY 40422-2094
Phone: (859) 236-1130
Fax: (859) 239-9384
Website:
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Health care specialties

SpecialtyCodeLicense #State
Other Service Providers / Specialist 174400000X
Student, Health Care / Student in an Organized Health Care Education/Training Program 390200000X
Dental Providers / Oral and Maxillofacial Surgery 1223S0112X 9346 Kentucky

Profile Details

NPI number 1598100372
LBN Legal business name Kolasa, Justin R
Credentials D.M.D., M.D.
Entity Individual
Sole proprietor 1 No
Enumeration date May 7th, 2013
Last updated Jan 18th, 2023 - 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 1598100372 NPPES
Kentucky MEDICAID 7100290020

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