Provider Demographics
NPI:1932110178
Name:LITE, SCOTT W (DMD)
Entity Type:Individual
Prefix:DR
First Name:SCOTT
Middle Name:W
Last Name:LITE
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 1:374 SOUTH MAIN STREET
Mailing Address - Street 2:
Mailing Address - City:SHARON
Mailing Address - State:MA
Mailing Address - Zip Code:02067
Mailing Address - Country:US
Mailing Address - Phone:781-784-7391
Mailing Address - Fax:
Practice Address - Street 1:374 SOUTH MAIN STREET
Practice Address - Street 2:
Practice Address - City:SHARON
Practice Address - State:MA
Practice Address - Zip Code:02067
Practice Address - Country:US
Practice Address - Phone:781-784-7391
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-08-11
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA127101223D0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223D0001XDental ProvidersDentistDental Public Health