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General NPI Number Information
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NPI Number | 1891616207
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Entity Type | Organization
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Legal Business Name | SCUTARI CARDOSO & CUNNINGHAM ORAL & MAXILLOFACIAL SURGERY LLP
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Dates
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Enumeration Date | 07/22/2026
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Last Update Date | 07/22/2026
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Provider Practice Location Address
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Address Line | 4000 MEDICAL CENTER DRIVE SUITE B13
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City | FAYETTEVILLE
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State | NY
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Zip | 13066
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Country | US
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Telephone | 315-671-4289
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Fax |
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Provider Business Mailing Address
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Address Line | 4000 MEDICAL CENTER DRIVE SUITE B13
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City | FAYETTEVILLE
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State | NY
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Zip | 13066
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Country | US
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Telephone | 315-671-4289
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Fax |
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Authorized Official
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Title or Position | OWNER/ORAL SURGEON
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Name | DR. PASQUALE SCUTARI JR.
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Credential | DDS
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Telephone | 315-263-4630
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 204E00000X
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Taxonomy Name | Oral & Maxillofacial Surgery (D.M.D.)
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License Number |
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License Number State |
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