Provider Demographics
NPI:1770242877
Name:ELIZABETH SKELLY DMD PC
Entity Type:Organization
Organization Name:ELIZABETH SKELLY DMD PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:ELIZABETH
Authorized Official - Middle Name:
Authorized Official - Last Name:SKELLY
Authorized Official - Suffix:
Authorized Official - Credentials:DMD
Authorized Official - Phone:610-252-8966
Mailing Address - Street 1:1625 NORTHAMPTON ST
Mailing Address - Street 2:
Mailing Address - City:EASTON
Mailing Address - State:PA
Mailing Address - Zip Code:18042-3131
Mailing Address - Country:US
Mailing Address - Phone:610-252-8966
Mailing Address - Fax:610-252-8966
Practice Address - Street 1:205 S 22ND ST
Practice Address - Street 2:
Practice Address - City:EASTON
Practice Address - State:PA
Practice Address - Zip Code:18042-3810
Practice Address - Country:US
Practice Address - Phone:484-695-2580
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:ELIZABETH SKELLY DMD PC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2021-12-16
Last Update Date:2021-12-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QD0000XAmbulatory Health Care FacilitiesClinic/CenterDental