Organization
CITY DENTAL SERVICE PROVIDER, PLLC
Active
Organization subpart
No
Provider details
NPI number
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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