Provider Demographics
NPI:1811609712
Name:HARBOR ENDODONTICS, PA
Entity type:Organization
Organization Name:HARBOR ENDODONTICS, PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:TIMOTHY
Authorized Official - Middle Name:
Authorized Official - Last Name:SKANE
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:410-952-8308
Mailing Address - Street 1:36 S CHARLES ST STE 1405
Mailing Address - Street 2:
Mailing Address - City:BALTIMORE
Mailing Address - State:MD
Mailing Address - Zip Code:21201-3109
Mailing Address - Country:US
Mailing Address - Phone:410-637-3636
Mailing Address - Fax:
Practice Address - Street 1:36 S CHARLES ST STE 1405
Practice Address - Street 2:
Practice Address - City:BALTIMORE
Practice Address - State:MD
Practice Address - Zip Code:21201-3109
Practice Address - Country:US
Practice Address - Phone:410-637-3636
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-12-22
Last Update Date:2022-12-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223E0200XDental ProvidersDentistEndodonticsGroup - Single Specialty