MEDICARE: MR. DAVID SCOTT TARICA DMD

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	1223G0001X	General Practice Dentistry	037532	NY

General Provider Information

NPI Number	:	1093816498
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MR. DAVID SCOTT TARICA DMD

Provider Business Mailing Address
First Line	:	145 GOLF VIEW DR
Second Line	:
City	:	JERICHO
State	:	NY
Zip	:	11753-2820
Country	:	US
Telephone Number	:	212-564-8164
Fax Number	:	212-564-2830

Provider Business Practice Location Address
First Line	:	225 W 35TH ST
Second Line	:
City	:	NEW YORK
State	:	NY
Zip	:	10001-1904
Country	:	US
Telephone Number	:	212-564-8164
Fax Number	:	212-244-4522

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	09/26/2006
Last Update Date	:	07/08/2007

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