Provider Demographics
NPI:1205590510
Name:SAL C ZAMMITTI DMD MMSC PLLC AND MATTHEW P GIDALY DDS PLLC V
Entity type:Organization
Organization Name:SAL C ZAMMITTI DMD MMSC PLLC AND MATTHEW P GIDALY DDS PLLC V
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/PARTNER
Authorized Official - Prefix:DR
Authorized Official - First Name:MATTHEW
Authorized Official - Middle Name:PHILIP
Authorized Official - Last Name:GIDALY
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:516-848-6762
Mailing Address - Street 1:4605 HYLAS LN STE B
Mailing Address - Street 2:
Mailing Address - City:HUNTERSVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:28078-9657
Mailing Address - Country:US
Mailing Address - Phone:704-456-9166
Mailing Address - Fax:704-448-0954
Practice Address - Street 1:4605 HYLAS LN STE B
Practice Address - Street 2:
Practice Address - City:HUNTERSVILLE
Practice Address - State:NC
Practice Address - Zip Code:28078-9657
Practice Address - Country:US
Practice Address - Phone:704-456-9166
Practice Address - Fax:704-448-0954
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-10-25
Last Update Date:2021-10-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QD0000XAmbulatory Health Care FacilitiesClinic/CenterDental