Provider Demographics
NPI:1861137119
Name:SKYLINE DENTAL
Entity type:Organization
Organization Name:SKYLINE DENTAL
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:ALIANA
Authorized Official - Middle Name:
Authorized Official - Last Name:HENKIN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:973-963-8181
Mailing Address - Street 1:133 JANWICH DR
Mailing Address - Street 2:
Mailing Address - City:MORGANVILLE
Mailing Address - State:NJ
Mailing Address - Zip Code:07751-1480
Mailing Address - Country:US
Mailing Address - Phone:732-822-7313
Mailing Address - Fax:
Practice Address - Street 1:223 MOUNTAIN AVE
Practice Address - Street 2:
Practice Address - City:SPRINGFIELD
Practice Address - State:NJ
Practice Address - Zip Code:07081-2213
Practice Address - Country:US
Practice Address - Phone:973-963-8181
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-05-02
Last Update Date:2022-05-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QD0000XAmbulatory Health Care FacilitiesClinic/CenterDental