Healthcare Provider Details

I. General information

NPI: 1629862016
Provider Name (Legal Business Name): KATHERINE THERESA SKOLA DMD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/08/2025
Last Update Date: 08/09/2026
Certification Date: 08/09/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3761 MAIN ST
WARRENSBURG NY
12885-1837
US

IV. Provider business mailing address

9 CAREY RD
QUEENSBURY NY
12804-7880
US

V. Phone/Fax

Practice location:
  • Phone: 518-623-3918
  • Fax: 518-623-4330
Mailing address:
  • Phone: 518-761-0300
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code122300000X
TaxonomyDentist
License Number065655
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: