Provider Demographics
NPI:1518090349
Name:SCIASCIA, SALVATORE G (DMD)
Entity Type:Individual
Prefix:DR
First Name:SALVATORE
Middle Name:G
Last Name:SCIASCIA
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 1:29 STATE RT 23 N
Mailing Address - Street 2:
Mailing Address - City:HAMBURG
Mailing Address - State:NJ
Mailing Address - Zip Code:07419-1419
Mailing Address - Country:US
Mailing Address - Phone:973-827-2200
Mailing Address - Fax:973-827-2457
Practice Address - Street 1:29 STATE RT 23 N
Practice Address - Street 2:
Practice Address - City:HAMBURG
Practice Address - State:NJ
Practice Address - Zip Code:07419-1419
Practice Address - Country:US
Practice Address - Phone:973-827-2200
Practice Address - Fax:973-827-2457
Is Sole Proprietor?:No
Enumeration Date:2007-03-13
Last Update Date:2008-01-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ155731223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice