Organization
CITY DENTAL SERVICE PROVIDER, PLLC
Active
Parent organization
CITY DENTAL SERVICE PROVIDER, PLLC
Organization subpart
Yes
Provider details
NPI number
Legal business name
CITY DENTAL SERVICE PROVIDER, PLLC
Authorized official
CHARLOTTE V DASCH (SR. DIRECTOR OF CREDENTIALING &PR)
(504) 638-0303
Entity
Organization
Contact information
Practice address
777 WHITE PLAINS RD, SCARSDALE, NY 10583-5000
(914) 472-9090
Mailing address
1610 54TH AVE N STE 205, NASHVILLE, TN 37209-1442
(615) 678-0759
Taxonomy
Speciality
Code
Description
License number
State
1223P0221X
Pediatric Dentistry
Primary
—
—
1223X0400X
Orthodontics and Dentofacial Orthopedics Dentistry
—
—
Other
Enumeration date
04/02/2026
Last updated
04/02/2026
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