# VITKUS, SCUTARI & CARDOSO ORAL SURGERY PC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1275618019
- **Authorized official:** DR. PASQUALE SCUTARI JR. DDS (ORAL MAXILLOFACIAL SURGEON)
- **Authorized official phone:** (315) 637-4476

## Contact information

- **Practice address:** 4000 MEDICAL CENTER DRIVE, SUITE B13, FAYETTEVILLE, NY 13066-1537
- **Practice address phone:** (315) 671-4289
- **Practice address fax:** (315) 637-1261
- **Mailing address:** 4000 MEDICAL CENTER DRIVE, SUITE B13, FAYETTEVILLE, NY 13066-1537
- **Mailing address phone:** (315) 671-4289
- **Mailing address fax:** (315) 637-1261

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 1223S0112X | Oral and Maxillofacial Surgery (Dentist) | 045842-1 | NY | Yes |
| 1223S0112X | Oral and Maxillofacial Surgery (Dentist) | — | NULL | — |
| 1223S0112X | Oral and Maxillofacial Surgery (Dentist) | — | — | — |

## Other

- **Enumeration date:** 10/26/2006
- **Last updated:** 05/06/2024