Healthcare Provider Details

I. General information

NPI: 1538803267
Provider Name (Legal Business Name): SAL C ZAMMITTI DMD MMSC PLLC AND MATTHEW P GIDALY DDS PLLC VI
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/27/2022
Last Update Date: 08/31/2024
Certification Date: 08/31/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4605 HYLAS LN STE B
HUNTERSVILLE NC
28078-9657
US

IV. Provider business mailing address

4605 HYLAS LN STE B
HUNTERSVILLE NC
28078-9657
US

V. Phone/Fax

Practice location:
  • Phone: 704-456-9166
  • Fax:
Mailing address:
  • Phone: 704-456-9166
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223P0221X
TaxonomyPediatric Dentistry
License Number
License Number State

VIII. Authorized Official

Name: DR. MATTHEW P GIDALY
Title or Position: OWNER/PARTNER
Credential: DDS MS
Phone: 516-848-6762