Provider Demographics
NPI:1386856672
Name:GRITZ, SCOTT I (DDS)
Entity Type:Individual
Prefix:DR
First Name:SCOTT
Middle Name:I
Last Name:GRITZ
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11906 DARNESTOWN ROAD
Mailing Address - Street 2:#A
Mailing Address - City:N POTOMAC
Mailing Address - State:MD
Mailing Address - Zip Code:20878
Mailing Address - Country:US
Mailing Address - Phone:301-926-2700
Mailing Address - Fax:301-926-3214
Practice Address - Street 1:11906 DARNESTOWN ROAD
Practice Address - Street 2:#A
Practice Address - City:N POTOMAC
Practice Address - State:MD
Practice Address - Zip Code:20878
Practice Address - Country:US
Practice Address - Phone:301-926-2700
Practice Address - Fax:301-926-3214
Is Sole Proprietor?:No
Enumeration Date:2007-05-07
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD9929122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist