Provider Demographics
NPI:1942359112
Name:SCALI, PHILIP P (DMD)
Entity Type:Individual
Prefix:DR
First Name:PHILIP
Middle Name:P
Last Name:SCALI
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 1:425 TRAPELO RD
Mailing Address - Street 2:
Mailing Address - City:BELMONT
Mailing Address - State:MA
Mailing Address - Zip Code:02478-1417
Mailing Address - Country:US
Mailing Address - Phone:617-489-7900
Mailing Address - Fax:617-489-7901
Practice Address - Street 1:425 TRAPELO RD
Practice Address - Street 2:
Practice Address - City:BELMONT
Practice Address - State:MA
Practice Address - Zip Code:02478-1417
Practice Address - Country:US
Practice Address - Phone:617-489-7900
Practice Address - Fax:617-489-7901
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-09
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA183741223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA881875OtherUNITED CONCORDIA
MAX07360OtherBLUE CROSS BLUE SHIELD