Healthcare Provider Details

I. General information

NPI: 1154144970
Provider Name (Legal Business Name): PRESTO DENTAL PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/01/2024
Last Update Date: 11/01/2024
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

36 DIVISION STREET
DERBY CT
06418
US

IV. Provider business mailing address

300 HARMON MEADOW BLVD FLOOR 2
SECAUCUS NJ
07094
US

V. Phone/Fax

Practice location:
  • Phone: 203-323-5439
  • Fax: 203-734-5444
Mailing address:
  • Phone: 973-578-8788
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code1223P0221X
TaxonomyPediatric Dentistry
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code1223S0112X
TaxonomyOral and Maxillofacial Surgery (Dentist)
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code1223X0400X
TaxonomyOrthodontics and Dentofacial Orthopedics Dentistry
License Number
License Number State
# 4
Primary TaxonomyY
Taxonomy Code1223G0001X
TaxonomyGeneral Practice Dentistry
License Number
License Number State

VIII. Authorized Official

Name: MR. MICHAEL SKOLNICK
Title or Position: OWNER
Credential: DMD
Phone: 908-469-9100