Organization
PEARLY WHITES PA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MICHAEL SKOLNICK DMD (PRESIDENT)
(908) 464-6789
Entity
Organization
Contact information
Practice address
501 SPRINGFIELD AVE FL 2, BERKELEY HEIGHTS, NJ 07922-1180
(908) 464-6789
(908) 464-6767
Mailing address
515 SPRINGFIELD AVE, 2ND FLOOR, BERKELEY HEIGHTS, NJ 07922-1180
(908) 464-6789
Taxonomy
Speciality
Code
Description
License number
State
1223E0200X
Endodontics
—
—
1223G0001X
General Practice Dentistry
—
—
1223P0221X
Pediatric Dentistry
22DI02349301
NJ
1223P0300X
Periodontics
—
—
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
—
—
1223X0400X
Orthodontics and Dentofacial Orthopedics Dentistry
Primary
22DI02353601
NJ
Other
Enumeration date
03/05/2013
Last updated
02/25/2020
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