Provider Demographics
NPI:1891844080
Name:SCOTTO, JAMISON (DMD)
Entity Type:Individual
Prefix:
First Name:JAMISON
Middle Name:
Last Name:SCOTTO
Suffix:
Gender:M
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1080 DAY HILL RD
Mailing Address - Street 2:
Mailing Address - City:WINDSOR
Mailing Address - State:CT
Mailing Address - Zip Code:06095-1781
Mailing Address - Country:US
Mailing Address - Phone:860-683-0243
Mailing Address - Fax:860-683-1157
Practice Address - Street 1:1080 DAY HILL RD
Practice Address - Street 2:
Practice Address - City:WINDSOR
Practice Address - State:CT
Practice Address - Zip Code:06095-1781
Practice Address - Country:US
Practice Address - Phone:860-683-0243
Practice Address - Fax:860-683-1157
Is Sole Proprietor?:No
Enumeration Date:2007-01-09
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT0092821223P0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223P0300XDental ProvidersDentistPeriodontics