Provider Demographics
NPI:1073104394
Name:SKYLANDS ORTHODONTICS, LLC
Entity Type:Organization
Organization Name:SKYLANDS ORTHODONTICS, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:MRS
Authorized Official - First Name:JINOY
Authorized Official - Middle Name:
Authorized Official - Last Name:CAUSBY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:973-729-9923
Mailing Address - Street 1:21 LAFAYETTE RD STE D
Mailing Address - Street 2:
Mailing Address - City:SPARTA
Mailing Address - State:NJ
Mailing Address - Zip Code:07871-3575
Mailing Address - Country:US
Mailing Address - Phone:973-729-9923
Mailing Address - Fax:973-729-0758
Practice Address - Street 1:21 LAFAYETTE RD STE D
Practice Address - Street 2:
Practice Address - City:SPARTA
Practice Address - State:NJ
Practice Address - Zip Code:07871-3575
Practice Address - Country:US
Practice Address - Phone:973-729-9923
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-01-29
Last Update Date:2021-01-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223X0400XDental ProvidersDentistOrthodontics and Dentofacial OrthopedicsGroup - Single Specialty