Provider Demographics
NPI:1447859509
Name:SCARSDALE PLAZA DENTAL SERVICES, PLLC
Entity type:Organization
Organization Name:SCARSDALE PLAZA DENTAL SERVICES, PLLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:DENTIST
Authorized Official - Prefix:DR
Authorized Official - First Name:KATARZYNA
Authorized Official - Middle Name:I
Authorized Official - Last Name:GILEWICZ
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:917-669-8789
Mailing Address - Street 1:1075 CENTRAL PARK AVE STE 414
Mailing Address - Street 2:
Mailing Address - City:SCARSDALE
Mailing Address - State:NY
Mailing Address - Zip Code:10583-3232
Mailing Address - Country:US
Mailing Address - Phone:917-669-8789
Mailing Address - Fax:
Practice Address - Street 1:1075 CENTRAL PARK AVE STE 414
Practice Address - Street 2:
Practice Address - City:SCARSDALE
Practice Address - State:NY
Practice Address - Zip Code:10583-3232
Practice Address - Country:US
Practice Address - Phone:917-669-8789
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-10-20
Last Update Date:2020-11-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty