Provider Demographics
NPI:1063295087
Name:MARYSVILLE FAMILY DENTISTRY-MATTHEW SCURRIA, DDS, LLC
Entity type:Organization
Organization Name:MARYSVILLE FAMILY DENTISTRY-MATTHEW SCURRIA, DDS, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:MATTHEW
Authorized Official - Middle Name:WILLIAM
Authorized Official - Last Name:SCURRIA
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:614-330-9151
Mailing Address - Street 1:1139 N MAPLE ST
Mailing Address - Street 2:
Mailing Address - City:MARYSVILLE
Mailing Address - State:OH
Mailing Address - Zip Code:43040-9794
Mailing Address - Country:US
Mailing Address - Phone:937-644-1115
Mailing Address - Fax:
Practice Address - Street 1:1139 N MAPLE ST
Practice Address - Street 2:
Practice Address - City:MARYSVILLE
Practice Address - State:OH
Practice Address - Zip Code:43040-9794
Practice Address - Country:US
Practice Address - Phone:937-644-1115
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-08-15
Last Update Date:2023-08-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QD0000XAmbulatory Health Care FacilitiesClinic/CenterDental