Provider Demographics
NPI:1689011033
Name:SCOTT A. BIALIK, DDS LLC
Entity Type:Organization
Organization Name:SCOTT A. BIALIK, DDS LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:SCOTT
Authorized Official - Middle Name:
Authorized Official - Last Name:BIALIK
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:203-788-1458
Mailing Address - Street 1:246 FEDERAL RD
Mailing Address - Street 2:SUITE D 13
Mailing Address - City:BROOKFIELD
Mailing Address - State:CT
Mailing Address - Zip Code:06804-2647
Mailing Address - Country:US
Mailing Address - Phone:203-791-2771
Mailing Address - Fax:
Practice Address - Street 1:246 FEDERAL RD
Practice Address - Street 2:SUITE D 13
Practice Address - City:BROOKFIELD
Practice Address - State:CT
Practice Address - Zip Code:06804-2647
Practice Address - Country:US
Practice Address - Phone:203-791-2771
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-05-24
Last Update Date:2015-02-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223P0221XDental ProvidersDentistPediatric DentistryGroup - Multi-Specialty
No1223G0001XDental ProvidersDentistGeneral PracticeGroup - Multi-Specialty