MEDICARE: PHILLIP ARSUFFI DMD LLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	261QD0000X	Dental Clinic/Center

General Provider Information

NPI Number	:	1437867868
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	PHILLIP ARSUFFI DMD LLC

Provider Business Mailing Address
First Line	:	761 GLENBROOK RD
Second Line	:
City	:	YOUNGSTOWN
State	:	OH
Zip	:	44512-2506
Country	:	US
Telephone Number	:	330-503-0859
Fax Number	:

Provider Business Practice Location Address
First Line	:	10309 MAIN ST
Second Line	:
City	:	NEW MIDDLETOWN
State	:	OH
Zip	:	44442-9717
Country	:	US
Telephone Number	:	330-542-9812
Fax Number	:

Authorized Official
Title or Position	:	DENTIST/OWNER
Name	:	PHILLIP ARSUFFI
Credential	:	DMD
Telephone Number	:	330-542-9812

Provider Enumeration Date	:	11/15/2022
Last Update Date	:	12/19/2022

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