Provider Demographics
NPI:1740904341
Name:SAL C ZAMMITTI DMD MMSC PLLC AND MATTHEW P GIDALY DDS PLLC III
Entity type:Organization
Organization Name:SAL C ZAMMITTI DMD MMSC PLLC AND MATTHEW P GIDALY DDS PLLC III
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER/PARTER
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 MS
Authorized Official - Phone:704-947-9991
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:704-947-9991
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:704-947-9991
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-09-28
Last Update Date:2023-02-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223X0400XDental ProvidersDentistOrthodontics and Dentofacial OrthopedicsGroup - Multi-Specialty