Provider Demographics
NPI:1215206198
Name:ANTHONY J. SCOMA, DDS INC.
Entity Type:Organization
Organization Name:ANTHONY J. SCOMA, DDS INC.
Other - Org Name:SEASIDE PEDIATRIC DENTISTRY & ORTHODONTICS
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:ANTHONY
Authorized Official - Middle Name:J
Authorized Official - Last Name:SCOMA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:858-551-9700
Mailing Address - Street 1:12036 SCRIPPS HIGHLAND DR STE 100
Mailing Address - Street 2:
Mailing Address - City:SAN DIEGO
Mailing Address - State:CA
Mailing Address - Zip Code:92131-5155
Mailing Address - Country:US
Mailing Address - Phone:858-271-4200
Mailing Address - Fax:
Practice Address - Street 1:12036 SCRIPPS HIGHLAND DR STE 100
Practice Address - Street 2:
Practice Address - City:SAN DIEGO
Practice Address - State:CA
Practice Address - Zip Code:92131-5155
Practice Address - Country:US
Practice Address - Phone:858-271-4200
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-12-21
Last Update Date:2014-08-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223P0221XDental ProvidersDentistPediatric DentistryGroup - Single Specialty