Provider Demographics
NPI:1760703524
Name:SCARPATI, DEBRA MIKOVCH (DD S)
Entity Type:Individual
Prefix:DR
First Name:DEBRA
Middle Name:MIKOVCH
Last Name:SCARPATI
Suffix:
Gender:F
Credentials:DD S
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1030 E WILLOW GROVE AVE
Mailing Address - Street 2:
Mailing Address - City:WYNDMOOR
Mailing Address - State:PA
Mailing Address - Zip Code:19038-7973
Mailing Address - Country:US
Mailing Address - Phone:215-233-1700
Mailing Address - Fax:
Practice Address - Street 1:1030 E WILLOW GROVE AVE
Practice Address - Street 2:
Practice Address - City:WYNDMOOR
Practice Address - State:PA
Practice Address - Zip Code:19038-7973
Practice Address - Country:US
Practice Address - Phone:215-233-1700
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-06-16
Last Update Date:2013-02-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PADS-021227-L1223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice