MEDICARE: PATRIZIA SCALIA DDS PLC

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	261QD0000X	Dental Clinic/Center	2901017203	MI

General Provider Information

NPI Number	:	1245684919
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	PATRIZIA SCALIA DDS PLC

Provider Business Mailing Address
First Line	:	235 SHAGBARK DR
Second Line	:
City	:	ROCHESTER HILLS
State	:	MI
Zip	:	48309-1818
Country	:	US
Telephone Number	:	248-425-1248
Fax Number	:

Provider Business Practice Location Address
First Line	:	235 SHAGBARK DR
Second Line	:
City	:	ROCHESTER HILLS
State	:	MI
Zip	:	48309-1818
Country	:	US
Telephone Number	:	248-425-1248
Fax Number	:

Authorized Official
Title or Position	:	OWNER DENTIST
Name	:	DR. PATRIZIA SCALIA
Credential	:	DDS
Telephone Number	:	248-425-1248

Provider Enumeration Date	:	04/19/2016
Last Update Date	:	04/19/2016

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