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General NPI Number Information
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NPI Number | 1730589474
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Entity Type | Individual
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Provider Name | SEAN SHKOLNIK D.D.S.
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Gender | Male
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Dates
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Enumeration Date | 08/31/2014
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Last Update Date | 09/29/2021
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Provider Practice Location Address
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Address Line | 9497 OLD PINE RD
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City | BOCA RATON
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State | FL
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Zip | 33428-3055
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Country | US
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Telephone | 305-336-4515
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Fax |
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Provider Business Mailing Address
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Address Line | 9497 OLD PINE RD
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City | BOCA RATON
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State | FL
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Zip | 33428-3055
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Country | US
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Telephone | 305-336-4515
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 122300000X
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Taxonomy Name | Dentist
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License Number | 20779
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License Number State | FL
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