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General NPI Number Information
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NPI Number | 1437364429
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Entity Type | Organization
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Legal Business Name | THOMAS M SCORZIELLO DMD LLC
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Dates
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Enumeration Date | 05/11/2007
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 601 HAMBURG TPKE SUITE 206
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City | WAYNE
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State | NJ
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Zip | 07470-2048
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Country | US
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Telephone | 973-904-1400
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Fax |
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Provider Business Mailing Address
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Address Line | 601 HAMBURG TPKE SUITE 206
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City | WAYNE
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State | NJ
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Zip | 07470-2048
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Country | US
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Telephone | 973-904-1400
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | DR. THOMAS M SCORZIELLO
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Credential | MS, DMD, MS
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Telephone | 973-904-1400
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1223P0300X
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Taxonomy Name | Periodontics
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License Number | DI17988
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License Number State | NJ
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