Provider Demographics
NPI:1942772603
Name:RAILROAD PLAZA DENTAL ASSOCIATES SPEC LLC
Entity Type:Organization
Organization Name:RAILROAD PLAZA DENTAL ASSOCIATES SPEC LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:MICHAEL
Authorized Official - Middle Name:ETHAN
Authorized Official - Last Name:SKOLNICK
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:973-578-8788
Mailing Address - Street 1:2 RAILROAD PLZ STE 2
Mailing Address - Street 2:
Mailing Address - City:WHIPPANY
Mailing Address - State:NJ
Mailing Address - Zip Code:07981-1548
Mailing Address - Country:US
Mailing Address - Phone:973-578-8788
Mailing Address - Fax:973-578-8799
Practice Address - Street 1:2 RAILROAD PLZ STE 2
Practice Address - Street 2:
Practice Address - City:WHIPPANY
Practice Address - State:NJ
Practice Address - Zip Code:07981-1548
Practice Address - Country:US
Practice Address - Phone:973-578-8788
Practice Address - Fax:973-578-8799
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-12-19
Last Update Date:2018-12-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223X0400XDental ProvidersDentistOrthodontics and Dentofacial OrthopedicsGroup - Multi-Specialty