Provider Demographics
NPI:1972620359
Name:SKROBOLA & SCHLOSSER DDS PC
Entity Type:Organization
Organization Name:SKROBOLA & SCHLOSSER DDS PC
Other - Org Name:DBA BRACESETTERS
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:MICHAEL
Authorized Official - Middle Name:G
Authorized Official - Last Name:SKROBOLA
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:845-342-1300
Mailing Address - Street 1:180 WISNER AVE
Mailing Address - Street 2:
Mailing Address - City:MIDDLETOWN
Mailing Address - State:NY
Mailing Address - Zip Code:10940-3221
Mailing Address - Country:US
Mailing Address - Phone:845-342-1300
Mailing Address - Fax:845-344-0013
Practice Address - Street 1:180 WISNER AVE
Practice Address - Street 2:
Practice Address - City:MIDDLETOWN
Practice Address - State:NY
Practice Address - Zip Code:10940-3221
Practice Address - Country:US
Practice Address - Phone:845-342-1300
Practice Address - Fax:845-344-0013
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-23
Last Update Date:2012-02-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY0401741223X0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223X0400XDental ProvidersDentistOrthodontics and Dentofacial OrthopedicsGroup - Single Specialty