Organization
BROADWAY ORAL SURGERY LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. MICHAEL SKOLNICK DMD (OWNER)
(908) 469-9100
Entity
Organization
Contact information
Practice address
223 BLOOMFIELD AVE, SUITE 2, NEWARK, NJ 07104
(973) 554-4565
Mailing address
223 BLOOMFIELD AVE, SUITE 2, NEWARK, NJ 07104
(973) 554-4565
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
—
—
1223P0221X
Pediatric Dentistry
—
—
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
—
—
1223X0400X
Orthodontics and Dentofacial Orthopedics Dentistry
—
—
Other
Enumeration date
11/26/2025
Last updated
11/26/2025
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