# ORANGE ST DENTAL ASSOCIATES LLC

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

## Provider details

- **NPI number:** 1962944967
- **Authorized official:** DR. MICHAEL SKOLNICK (OWNER)
- **Authorized official phone:** (973) 578-8788

## Contact information

- **Practice address:** 509 ORANGE ST, NEWARK, NJ 07107-2128
- **Practice address phone:** (973) 578-8788
- **Practice address fax:** (973) 578-8799
- **Mailing address:** 509 ORANGE ST, NEWARK, NJ 07107-2128
- **Mailing address phone:** (973) 578-8788
- **Mailing address fax:** (973) 578-8799

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 122300000X | Dentist | — | — | — |
| 1223E0200X | Endodontics | — | — | — |
| 1223G0001X | General Practice Dentistry | — | — | Yes |
| 1223P0221X | Pediatric Dentistry | — | — | — |
| 1223S0112X | Oral and Maxillofacial Surgery (Dentist) | — | — | — |
| 1223X0400X | Orthodontics and Dentofacial Orthopedics Dentistry | — | — | — |
| 124Q00000X | Dental Hygienist | — | — | — |
| 126800000X | Dental Assistant | — | — | — |

## Other

- **Enumeration date:** 11/08/2016
- **Last updated:** 02/25/2020