Provider Demographics
NPI:1154434363
Name:DENTAL ARTS OF SCARSDALE, PC
Entity type:Organization
Organization Name:DENTAL ARTS OF SCARSDALE, PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER PARTNER
Authorized Official - Prefix:DR
Authorized Official - First Name:MARIA
Authorized Official - Middle Name:E
Authorized Official - Last Name:GENNARELLI
Authorized Official - Suffix:
Authorized Official - Credentials:DMD
Authorized Official - Phone:914-722-0111
Mailing Address - Street 1:75 BROOK ST
Mailing Address - Street 2:
Mailing Address - City:SCARSDALE
Mailing Address - State:NY
Mailing Address - Zip Code:10583-5147
Mailing Address - Country:US
Mailing Address - Phone:914-722-0111
Mailing Address - Fax:914-722-6052
Practice Address - Street 1:75 BROOK ST
Practice Address - Street 2:
Practice Address - City:SCARSDALE
Practice Address - State:NY
Practice Address - Zip Code:10583-5147
Practice Address - Country:US
Practice Address - Phone:914-722-0111
Practice Address - Fax:914-722-6052
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-15
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty