Provider Demographics
NPI:1093816498
Name:TARICA, DAVID SCOTT (DMD)
Entity Type:Individual
Prefix:MR
First Name:DAVID
Middle Name:SCOTT
Last Name:TARICA
Suffix:
Gender:M
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:145 GOLF VIEW DR
Mailing Address - Street 2:
Mailing Address - City:JERICHO
Mailing Address - State:NY
Mailing Address - Zip Code:11753-2820
Mailing Address - Country:US
Mailing Address - Phone:212-564-8164
Mailing Address - Fax:212-564-2830
Practice Address - Street 1:225 W 35TH ST
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10001-1904
Practice Address - Country:US
Practice Address - Phone:212-564-8164
Practice Address - Fax:212-244-4522
Is Sole Proprietor?:No
Enumeration Date:2006-09-26
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY0375321223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice