Provider Demographics
NPI:1730273350
Name:MARIE G SCOTT & STEPHANIE FOSTER DMD
Entity type:Organization
Organization Name:MARIE G SCOTT & STEPHANIE FOSTER DMD
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MRS
Authorized Official - First Name:STEPHANIE
Authorized Official - Middle Name:HEYDT
Authorized Official - Last Name:MCGANN
Authorized Official - Suffix:
Authorized Official - Credentials:DMD
Authorized Official - Phone:610-558-0416
Mailing Address - Street 1:PO BOX 904
Mailing Address - Street 2:
Mailing Address - City:CONCORDVILLE
Mailing Address - State:PA
Mailing Address - Zip Code:19331
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:
Practice Address - City:CONCORDVILLE
Practice Address - State:PA
Practice Address - Zip Code:19331
Practice Address - Country:US
Practice Address - Phone:610-558-0416
Practice Address - Fax:610-558-1005
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-03
Last Update Date:2008-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PADS026052L122300000X
PADS024345L122300000X
PA806675451223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Multi-Specialty
No122300000XDental ProvidersDentistGroup - Multi-Specialty