Provider Demographics
NPI:1669712410
Name:SCOTT, MARIE G (DMD)
Entity type:Individual
Prefix:DR
First Name:MARIE
Middle Name:G
Last Name:SCOTT
Suffix:
Gender:F
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:736 BALTIMORE PIKE
Mailing Address - Street 2:SUITE 7
Mailing Address - City:GLEN MILLS
Mailing Address - State:PA
Mailing Address - Zip Code:19342-1074
Mailing Address - Country:US
Mailing Address - Phone:610-558-0416
Mailing Address - Fax:610-558-1005
Practice Address - Street 1:736 BALTIMORE PIKE
Practice Address - Street 2:SUITE 7
Practice Address - City:GLEN MILLS
Practice Address - State:PA
Practice Address - Zip Code:19342-1074
Practice Address - Country:US
Practice Address - Phone:610-558-0416
Practice Address - Fax:610-558-1005
Is Sole Proprietor?:No
Enumeration Date:2013-02-14
Last Update Date:2013-02-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PADS024345L122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist