Provider Demographics
NPI:1548479033
Name:RICHARD L. SCOTTI D.D.S. P.A.
Entity type:Organization
Organization Name:RICHARD L. SCOTTI D.D.S. P.A.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DENTIST-OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:RICHARD
Authorized Official - Middle Name:L
Authorized Official - Last Name:SCOTTI
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:732-591-5560
Mailing Address - Street 1:470 STATE ROUTE 79
Mailing Address - Street 2:
Mailing Address - City:MORGANVILLE
Mailing Address - State:NJ
Mailing Address - Zip Code:07751-4700
Mailing Address - Country:US
Mailing Address - Phone:732-591-5560
Mailing Address - Fax:732-591-2292
Practice Address - Street 1:470 STATE ROUTE 79
Practice Address - Street 2:
Practice Address - City:MORGANVILLE
Practice Address - State:NJ
Practice Address - Zip Code:07751-4700
Practice Address - Country:US
Practice Address - Phone:732-591-5560
Practice Address - Fax:732-591-2292
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-21
Last Update Date:2013-01-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJDI159121223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty