Provider Demographics
NPI:1255165205
Name:SAL C ZAMMITTI DMD MMSC PLLC AND MATTHEW P GIDALY DDS PLLC VIII
Entity type:Organization
Organization Name:SAL C ZAMMITTI DMD MMSC PLLC AND MATTHEW P GIDALY DDS PLLC VIII
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:
Authorized Official - Last Name:GIDALY
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:516-848-6762
Mailing Address - Street 1:4079 HARRIS SQUARE DR
Mailing Address - Street 2:
Mailing Address - City:HARRISBURG
Mailing Address - State:NC
Mailing Address - Zip Code:28075-5104
Mailing Address - Country:US
Mailing Address - Phone:516-848-6762
Mailing Address - Fax:
Practice Address - Street 1:4079 HARRIS SQUARE DR
Practice Address - Street 2:
Practice Address - City:HARRISBURG
Practice Address - State:NC
Practice Address - Zip Code:28075-5104
Practice Address - Country:US
Practice Address - Phone:516-848-6762
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-08-30
Last Update Date:2024-09-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223P0221XDental ProvidersDentistPediatric DentistryGroup - Single Specialty