Provider Demographics
NPI:1154448751
Name:KARETH, SCOTT KENNETH (DENTIST)
Entity Type:Individual
Prefix:DR
First Name:SCOTT
Middle Name:KENNETH
Last Name:KARETH
Suffix:
Gender:M
Credentials:DENTIST
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4388 THOMASSON DR
Mailing Address - Street 2:
Mailing Address - City:NAPLES
Mailing Address - State:FL
Mailing Address - Zip Code:34112
Mailing Address - Country:US
Mailing Address - Phone:239-417-1553
Mailing Address - Fax:239-417-1822
Practice Address - Street 1:4388 THOMASSON DR
Practice Address - Street 2:
Practice Address - City:NAPLES
Practice Address - State:FL
Practice Address - Zip Code:34112-6767
Practice Address - Country:US
Practice Address - Phone:239-417-1553
Practice Address - Fax:239-417-1822
Is Sole Proprietor?:No
Enumeration Date:2007-03-26
Last Update Date:2011-12-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLDN 19591122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist