Provider Demographics
NPI:1649460718
Name:LEVY, SCOTT ERIC (DDS)
Entity type:Individual
Prefix:DR
First Name:SCOTT
Middle Name:ERIC
Last Name:LEVY
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 1:616 FREDERICK RD
Mailing Address - Street 2:
Mailing Address - City:CATONSVILLE
Mailing Address - State:MD
Mailing Address - Zip Code:21228-4625
Mailing Address - Country:US
Mailing Address - Phone:410-747-1115
Mailing Address - Fax:
Practice Address - Street 1:1215 W BALTIMORE PIKE STE 9
Practice Address - Street 2:
Practice Address - City:MEDIA
Practice Address - State:PA
Practice Address - Zip Code:19063-5540
Practice Address - Country:US
Practice Address - Phone:484-444-2664
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-07-25
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PADS0396371223E0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223E0200XDental ProvidersDentistEndodontics