Healthcare Provider Details
I. General information
NPI: 1053526806
Provider Name (Legal Business Name): BARRY P SKALER DDS
Entity Type: Individual
Gender: Male
Sole Proprietor: N
II. Dates (important events)
Enumeration Date: 05/14/2007
Last Update Date: 12/21/2011
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
932 S MAIN ST
PLEASANTVILLE NJ
08232-3646
US
IV. Provider business mailing address
860 S WHITE HORSE PIKE
HAMMONTON NJ
08037-2018
US
V. Phone/Fax
- Phone: 609-383-0880
- Fax: 609-383-9123
- Phone: 609-561-9150
- Fax: 609-561-9383
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 1223G0001X |
| Taxonomy | General Practice Dentistry |
| License Number | 22DI00821700 |
| License Number State | NJ |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: