Provider Demographics
NPI:1942584198
Name:A & B SCARSDALE DENTAL PLLC
Entity Type:Organization
Organization Name:A & B SCARSDALE DENTAL PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR DDS
Authorized Official - Prefix:
Authorized Official - First Name:ALEXANDER
Authorized Official - Middle Name:
Authorized Official - Last Name:MUSHEYEV
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:914-472-1555
Mailing Address - Street 1:130 GARTH RD
Mailing Address - Street 2:
Mailing Address - City:SCARSDALE
Mailing Address - State:NY
Mailing Address - Zip Code:10583-3750
Mailing Address - Country:US
Mailing Address - Phone:914-472-1555
Mailing Address - Fax:914-472-0399
Practice Address - Street 1:130 GARTH RD
Practice Address - Street 2:
Practice Address - City:SCARSDALE
Practice Address - State:NY
Practice Address - Zip Code:10583-3750
Practice Address - Country:US
Practice Address - Phone:914-472-1555
Practice Address - Fax:914-472-0399
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-10-06
Last Update Date:2011-10-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Multi-Specialty