Provider Demographics
NPI:1699840256
Name:LESLIE ANN SKURLA DMD PA
Entity type:Organization
Organization Name:LESLIE ANN SKURLA DMD PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:LESLIE
Authorized Official - Middle Name:A
Authorized Official - Last Name:SKURLA
Authorized Official - Suffix:
Authorized Official - Credentials:DMD
Authorized Official - Phone:973-386-0300
Mailing Address - Street 1:12 TROY HILLS ROAD
Mailing Address - Street 2:
Mailing Address - City:WHIPPANY
Mailing Address - State:NJ
Mailing Address - Zip Code:07981
Mailing Address - Country:US
Mailing Address - Phone:973-386-0300
Mailing Address - Fax:973-386-1117
Practice Address - Street 1:12 TROY HILLS ROAD
Practice Address - Street 2:
Practice Address - City:WHIPPANY
Practice Address - State:NJ
Practice Address - Zip Code:07981
Practice Address - Country:US
Practice Address - Phone:973-386-0300
Practice Address - Fax:973-386-1117
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-11-21
Last Update Date:2012-12-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ12293122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Multi-Specialty