Provider Demographics
NPI:1154164333
Name:SKYLINE HEALTHY SMILES FAMILY DENTAL PA
Entity type:Organization
Organization Name:SKYLINE HEALTHY SMILES FAMILY DENTAL PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DENTIST
Authorized Official - Prefix:DR
Authorized Official - First Name:MADHAVI
Authorized Official - Middle Name:
Authorized Official - Last Name:KARNAM
Authorized Official - Suffix:
Authorized Official - Credentials:DMD
Authorized Official - Phone:267-421-2073
Mailing Address - Street 1:5500 SKYLINE DR STE 2
Mailing Address - Street 2:
Mailing Address - City:WILMINGTON
Mailing Address - State:DE
Mailing Address - Zip Code:19808-1772
Mailing Address - Country:US
Mailing Address - Phone:267-421-2073
Mailing Address - Fax:
Practice Address - Street 1:5500 SKYLINE DR STE 2
Practice Address - Street 2:
Practice Address - City:WILMINGTON
Practice Address - State:DE
Practice Address - Zip Code:19808-1772
Practice Address - Country:US
Practice Address - Phone:267-421-2073
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-06-17
Last Update Date:2024-06-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QD0000XAmbulatory Health Care FacilitiesClinic/CenterDental