Provider Demographics
NPI:1003293168
Name:SCARSDALE DENTAL GROUP
Entity Type:Organization
Organization Name:SCARSDALE DENTAL GROUP
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:DAVID
Authorized Official - Middle Name:C
Authorized Official - Last Name:FURNARI
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:914-723-4707
Mailing Address - Street 1:14 HARWOOD COURT
Mailing Address - Street 2:STE 211
Mailing Address - City:SCARSDALE
Mailing Address - State:NY
Mailing Address - Zip Code:10583
Mailing Address - Country:US
Mailing Address - Phone:914-723-4707
Mailing Address - Fax:914-723-6209
Practice Address - Street 1:14 HARWOOD CT.
Practice Address - Street 2:STE 211
Practice Address - City:SCARSDALE
Practice Address - State:NY
Practice Address - Zip Code:10583
Practice Address - Country:US
Practice Address - Phone:914-723-4707
Practice Address - Fax:914-723-6209
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-04-28
Last Update Date:2015-04-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY040188122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Single Specialty