Provider Demographics
NPI:1043559321
Name:SCOTTI, RICHARD LOUIS (DDS)
Entity type:Individual
Prefix:DR
First Name:RICHARD
Middle Name:LOUIS
Last Name:SCOTTI
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 1:2305 WOOD AVE
Mailing Address - Street 2:
Mailing Address - City:ROSELLE
Mailing Address - State:NJ
Mailing Address - Zip Code:07203-2939
Mailing Address - Country:US
Mailing Address - Phone:908-486-4521
Mailing Address - Fax:908-241-2176
Practice Address - Street 1:2305 WOOD AVE
Practice Address - Street 2:
Practice Address - City:ROSELLE
Practice Address - State:NJ
Practice Address - Zip Code:07203-2939
Practice Address - Country:US
Practice Address - Phone:908-486-4521
Practice Address - Fax:908-241-2176
Is Sole Proprietor?:No
Enumeration Date:2013-02-07
Last Update Date:2013-02-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJNJ DI 15912122300000X
NV4479122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist