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General NPI Number Information
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NPI Number | 1902991730
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Entity Type | Organization
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Legal Business Name | JOHN M SCARAMELLA DDS INC
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Dates
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Enumeration Date | 10/04/2006
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 23450 LYONS AVE A
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City | NEWHALL
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State | CA
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Zip | 91321-5778
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Country | US
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Telephone | 661-254-0390
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Fax | 661-254-2772
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Provider Business Mailing Address
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Address Line | 23450 LYONS AVE A
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City | NEWHALL
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State | CA
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Zip | 91321-5778
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Country | US
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Telephone | 661-254-0390
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Fax | 661-254-2772
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. JOHN M SCARAMELLA
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Credential | ORAL MAXILLOFACIAL
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Telephone | 661-254-0390
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1223S0112X
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Taxonomy Name | Oral and Maxillofacial Surgery (Dentist)
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License Number |
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License Number State |
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