Provider Demographics
NPI:1467801910
Name:DAVID A SCARDELLA DMD PC
Entity Type:Organization
Organization Name:DAVID A SCARDELLA DMD PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:DAVID
Authorized Official - Middle Name:
Authorized Official - Last Name:SCARDELLA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:781-934-9444
Mailing Address - Street 1:33 ENTERPRISE ST
Mailing Address - Street 2:SUITE 9
Mailing Address - City:DUXBURY
Mailing Address - State:MA
Mailing Address - Zip Code:02332-3330
Mailing Address - Country:US
Mailing Address - Phone:781-934-9444
Mailing Address - Fax:781-934-9448
Practice Address - Street 1:33 ENTERPRISE ST
Practice Address - Street 2:SUITE 9
Practice Address - City:DUXBURY
Practice Address - State:MA
Practice Address - Zip Code:02332-3330
Practice Address - Country:US
Practice Address - Phone:781-934-9444
Practice Address - Fax:781-934-9448
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-06-06
Last Update Date:2016-06-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty