Provider Demographics
NPI:1396838827
Name:SCELFO, PETER JOSEPH (DDS, FAGD)
Entity Type:Individual
Prefix:DR
First Name:PETER
Middle Name:JOSEPH
Last Name:SCELFO
Suffix:
Gender:M
Credentials:DDS, FAGD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10466 GEORGETOWN DRIVE
Mailing Address - Street 2:
Mailing Address - City:SPOTSYLVANIA
Mailing Address - State:VA
Mailing Address - Zip Code:22553
Mailing Address - Country:US
Mailing Address - Phone:540-898-8181
Mailing Address - Fax:540-898-6960
Practice Address - Street 1:10466 GEORGETOWN DRIVE
Practice Address - Street 2:
Practice Address - City:SPOTSYLVANIA
Practice Address - State:VA
Practice Address - Zip Code:22553
Practice Address - Country:US
Practice Address - Phone:540-898-8181
Practice Address - Fax:540-898-6960
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-02
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA054821223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice