Provider Demographics
NPI:1659580173
Name:ALISON M. SCAVUZZO DMD LLC
Entity Type:Organization
Organization Name:ALISON M. SCAVUZZO DMD LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:ALISON
Authorized Official - Middle Name:MARY
Authorized Official - Last Name:SCAVUZZO
Authorized Official - Suffix:
Authorized Official - Credentials:DMD
Authorized Official - Phone:724-776-1190
Mailing Address - Street 1:1260 FREEDOM CRIDER RD
Mailing Address - Street 2:SUITE 2
Mailing Address - City:FREEDOM
Mailing Address - State:PA
Mailing Address - Zip Code:15042-9391
Mailing Address - Country:US
Mailing Address - Phone:724-776-1190
Mailing Address - Fax:724-776-1190
Practice Address - Street 1:1260 FREEDOM CRIDER RD
Practice Address - Street 2:SUITE 2
Practice Address - City:FREEDOM
Practice Address - State:PA
Practice Address - Zip Code:15042-9391
Practice Address - Country:US
Practice Address - Phone:724-776-1190
Practice Address - Fax:724-776-1190
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-21
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PADS028792L1223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty