Provider Demographics
NPI:1740509942
Name:SCOTT, STUART ANTHONY (DDS)
Entity type:Individual
Prefix:DR
First Name:STUART
Middle Name:ANTHONY
Last Name:SCOTT
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 1:804 PERSHING DR
Mailing Address - Street 2:SUITE 106
Mailing Address - City:SILVER SPRING
Mailing Address - State:MD
Mailing Address - Zip Code:20910-4434
Mailing Address - Country:US
Mailing Address - Phone:301-589-8191
Mailing Address - Fax:301-589-8192
Practice Address - Street 1:804 PERSHING DR
Practice Address - Street 2:SUITE 106
Practice Address - City:SILVER SPRING
Practice Address - State:MD
Practice Address - Zip Code:20910-4434
Practice Address - Country:US
Practice Address - Phone:301-589-8191
Practice Address - Fax:301-589-8192
Is Sole Proprietor?:No
Enumeration Date:2010-05-27
Last Update Date:2010-05-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD12356122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD1710190541OtherFACILITY NPI