Provider Demographics
NPI:1497488084
Name:PALMA AND NARDOZZA DENTAL SERVICES
Entity Type:Organization
Organization Name:PALMA AND NARDOZZA DENTAL SERVICES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:AUTHORIZED OFFICIAL
Authorized Official - Prefix:
Authorized Official - First Name:CASEY
Authorized Official - Middle Name:
Authorized Official - Last Name:MORSE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:856-272-4735
Mailing Address - Street 1:PO BOX 4008
Mailing Address - Street 2:
Mailing Address - City:LANCASTER
Mailing Address - State:PA
Mailing Address - Zip Code:17604-4008
Mailing Address - Country:US
Mailing Address - Phone:315-468-4100
Mailing Address - Fax:
Practice Address - Street 1:1638 W GENESEE ST
Practice Address - Street 2:
Practice Address - City:SYRACUSE
Practice Address - State:NY
Practice Address - Zip Code:13204-1996
Practice Address - Country:US
Practice Address - Phone:315-468-4100
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:PALMA AND NARDOZZA DENTAL SERVICES PC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2022-07-01
Last Update Date:2022-07-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY042879OtherNEW YORK STATE BOARD OF DENTISTRY