Provider Demographics
NPI:1689797938
Name:SKOLER & DIMARZIO ORTHODONTICS LLC
Entity Type:Organization
Organization Name:SKOLER & DIMARZIO ORTHODONTICS LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:PETER
Authorized Official - Middle Name:MATTHEW
Authorized Official - Last Name:SKOLER
Authorized Official - Suffix:
Authorized Official - Credentials:DMD
Authorized Official - Phone:617-770-3838
Mailing Address - Street 1:300 CONGRESS ST
Mailing Address - Street 2:SUITE 307
Mailing Address - City:QUINCY
Mailing Address - State:MA
Mailing Address - Zip Code:02169-0907
Mailing Address - Country:US
Mailing Address - Phone:617-770-3838
Mailing Address - Fax:
Practice Address - Street 1:300 CONGRESS ST
Practice Address - Street 2:SUITE 307
Practice Address - City:QUINCY
Practice Address - State:MA
Practice Address - Zip Code:02169-0907
Practice Address - Country:US
Practice Address - Phone:617-770-3838
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-04-09
Last Update Date:2010-09-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223X0400XDental ProvidersDentistOrthodontics and Dentofacial OrthopedicsGroup - Single Specialty