Provider Demographics
NPI:1346300860
Name:KALIKA, BORIS (DMD)
Entity Type:Individual
Prefix:DR
First Name:BORIS
Middle Name:
Last Name:KALIKA
Suffix:
Gender:M
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:54 W JIMMIE LEEDS RD
Mailing Address - Street 2:SUITE 6
Mailing Address - City:GALLOWAY
Mailing Address - State:NJ
Mailing Address - Zip Code:08205-9438
Mailing Address - Country:US
Mailing Address - Phone:609-748-9600
Mailing Address - Fax:609-748-9611
Practice Address - Street 1:54 W JIMMIE LEEDS RD
Practice Address - Street 2:SUITE 6
Practice Address - City:GALLOWAY
Practice Address - State:NJ
Practice Address - Zip Code:08205-9438
Practice Address - Country:US
Practice Address - Phone:609-748-9600
Practice Address - Fax:609-748-9611
Is Sole Proprietor?:No
Enumeration Date:2006-12-12
Last Update Date:2011-10-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ22DI022432001223S0112X
PADS0375441223S0112X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223S0112XDental ProvidersDentistOral and Maxillofacial Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA1025048500001Medicaid
PA191191RA9Medicare PIN