Provider Demographics
NPI:1356078786
Name:CARLA ELLEN SKAATES DDS PC
Entity type:Organization
Organization Name:CARLA ELLEN SKAATES DDS PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DENTIST
Authorized Official - Prefix:
Authorized Official - First Name:CARLA
Authorized Official - Middle Name:ELLEN
Authorized Official - Last Name:SKAATES
Authorized Official - Suffix:
Authorized Official - Credentials:DDS PC
Authorized Official - Phone:906-228-9592
Mailing Address - Street 1:1320 W RIDGE ST
Mailing Address - Street 2:
Mailing Address - City:MARQUETTE
Mailing Address - State:MI
Mailing Address - Zip Code:49855-3194
Mailing Address - Country:US
Mailing Address - Phone:906-228-9592
Mailing Address - Fax:906-228-5855
Practice Address - Street 1:1320 W RIDGE ST
Practice Address - Street 2:
Practice Address - City:MARQUETTE
Practice Address - State:MI
Practice Address - Zip Code:49855-3194
Practice Address - Country:US
Practice Address - Phone:906-228-9592
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-08-05
Last Update Date:2022-08-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QD0000XAmbulatory Health Care FacilitiesClinic/CenterDental