Organization
CHILDSMILES GROUP HOLDINGS LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MICHAEL SKOLNICK (OWNER)
(973) 578-8788
Entity
Organization
Contact information
Practice address
45 BLEEKER ST, NEWARK, NJ 07102-1913
(973) 578-8788
(973) 578-8799
Mailing address
45 BLEEKER ST, NEWARK, NJ 07102-1913
(973) 578-8788
(973) 578-8799
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
—
—
1223E0200X
Endodontics
—
—
1223G0001X
General Practice Dentistry
—
—
1223P0106X
Oral and Maxillofacial Pathology Dentistry
—
—
1223P0221X
Pediatric Dentistry
—
—
1223P0300X
Periodontics
—
—
1223X0400X
Orthodontics and Dentofacial Orthopedics Dentistry
Primary
—
—
124Q00000X
Dental Hygienist
—
—
126800000X
Dental Assistant
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
NONE
NONE
—
Enumeration date
03/11/2020
Last updated
03/11/2020
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