Provider Demographics
NPI:1881898427
Name:SCOTT STEIN, DDS, LLC
Entity type:Organization
Organization Name:SCOTT STEIN, DDS, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:FINANCIAL OFFICE MANAGER
Authorized Official - Prefix:MRS
Authorized Official - First Name:JUDY
Authorized Official - Middle Name:
Authorized Official - Last Name:OWENS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:585-586-4080
Mailing Address - Street 1:20 N MAIN ST
Mailing Address - Street 2:
Mailing Address - City:PITTSFORD
Mailing Address - State:NY
Mailing Address - Zip Code:14534-1303
Mailing Address - Country:US
Mailing Address - Phone:585-586-4080
Mailing Address - Fax:585-586-0464
Practice Address - Street 1:20 N MAIN ST
Practice Address - Street 2:
Practice Address - City:PITTSFORD
Practice Address - State:NY
Practice Address - Zip Code:14534-1303
Practice Address - Country:US
Practice Address - Phone:585-586-4080
Practice Address - Fax:585-586-0464
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-06-14
Last Update Date:2007-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY0449401223X0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223X0400XDental ProvidersDentistOrthodontics and Dentofacial OrthopedicsGroup - Single Specialty