Provider Demographics
NPI:1538340112
Name:HAROLD F. DEMSKO, D.D.S.,P.C.
Entity type:Organization
Organization Name:HAROLD F. DEMSKO, D.D.S.,P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:HAROLD
Authorized Official - Middle Name:F
Authorized Official - Last Name:DEMSKO
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:757-242-6781
Mailing Address - Street 1:70 E WINDSOR BLVD
Mailing Address - Street 2:SUITE D
Mailing Address - City:WINDSOR
Mailing Address - State:VA
Mailing Address - Zip Code:23487-9443
Mailing Address - Country:US
Mailing Address - Phone:757-242-6781
Mailing Address - Fax:757-242-6789
Practice Address - Street 1:70 E WINDSOR BLVD
Practice Address - Street 2:SUITE D
Practice Address - City:WINDSOR
Practice Address - State:VA
Practice Address - Zip Code:23487-9443
Practice Address - Country:US
Practice Address - Phone:757-242-6781
Practice Address - Fax:757-242-6789
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-11-24
Last Update Date:2007-11-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA6559261Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261Q00000XAmbulatory Health Care FacilitiesClinic/Center
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA108857OtherDORAL
VA7852151Medicaid