# RAYMOND J SKOSKY, DDS,LLC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1144686320
- **Authorized official:** RAYMOND J SKOSKY DDS (SOLE MEMBER)
- **Authorized official phone:** (314) 353-0263

## Contact information

- **Practice address:** 5530 VIRGINIA AVE, SAINT LOUIS, MO 63111-1939
- **Practice address phone:** (314) 353-0263
- **Practice address fax:** (314) 353-0263
- **Mailing address:** 5530 VIRGINIA AVE, SAINT LOUIS, MO 63111-1939
- **Mailing address phone:** (314) 353-0263
- **Mailing address fax:** (314) 353-0263

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 261QD0000X | Dental Clinic/Center | 014508 | MO | Yes |

## Other

- **Enumeration date:** 01/04/2016
- **Last updated:** 01/04/2016