Provider Demographics
NPI:1447383765
Name:SKY, NIKOLAY (DDS)
Entity Type:Individual
Prefix:DR
First Name:NIKOLAY
Middle Name:
Last Name:SKY
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:MCGUIRE AIR FORCE BASE
Mailing Address - Street 2:
Mailing Address - City:NEW HANOVER
Mailing Address - State:NJ
Mailing Address - Zip Code:08641
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:MCGUIRE AIR FORCE BASE
Practice Address - Street 2:
Practice Address - City:NEW HANOVER
Practice Address - State:NJ
Practice Address - Zip Code:08641
Practice Address - Country:US
Practice Address - Phone:609-745-3709
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-03-14
Last Update Date:2007-08-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT0097431223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice