Provider Demographics
NPI:1447675772
Name:SKURLA, LESLIE (DMD)
Entity type:Individual
Prefix:DR
First Name:LESLIE
Middle Name:
Last Name:SKURLA
Suffix:
Gender:F
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:12 TROY HILLS RD
Mailing Address - Street 2:
Mailing Address - City:WHIPPANY
Mailing Address - State:NJ
Mailing Address - Zip Code:07981-1538
Mailing Address - Country:US
Mailing Address - Phone:973-386-0300
Mailing Address - Fax:973-386-1117
Practice Address - Street 1:12 TROY HILLS RD
Practice Address - Street 2:
Practice Address - City:WHIPPANY
Practice Address - State:NJ
Practice Address - Zip Code:07981-1538
Practice Address - Country:US
Practice Address - Phone:973-386-0300
Practice Address - Fax:973-386-1117
Is Sole Proprietor?:No
Enumeration Date:2014-02-24
Last Update Date:2014-02-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ22D101229300122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist