Provider Demographics
NPI:1770161648
Name:UY SCUTI DENTAL LLC
Entity type:Organization
Organization Name:UY SCUTI DENTAL LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGER
Authorized Official - Prefix:DR
Authorized Official - First Name:EMILIA
Authorized Official - Middle Name:VIOLA
Authorized Official - Last Name:VAJDA
Authorized Official - Suffix:
Authorized Official - Credentials:DMD
Authorized Official - Phone:781-325-5371
Mailing Address - Street 1:43 RYAN FARM RD
Mailing Address - Street 2:
Mailing Address - City:WINDHAM
Mailing Address - State:NH
Mailing Address - Zip Code:03087-1849
Mailing Address - Country:US
Mailing Address - Phone:781-325-5371
Mailing Address - Fax:
Practice Address - Street 1:1B WALL STREET
Practice Address - Street 2:UNIT 208
Practice Address - City:WINDHAM
Practice Address - State:NH
Practice Address - Zip Code:03087
Practice Address - Country:US
Practice Address - Phone:781-325-5371
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-03-31
Last Update Date:2021-03-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QD0000XAmbulatory Health Care FacilitiesClinic/CenterDental