Provider Demographics
NPI:1104984582
Name:ROTHBART, SCOTT IAN (DDS)
Entity type:Individual
Prefix:DR
First Name:SCOTT
Middle Name:IAN
Last Name:ROTHBART
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 1:32 CHERRY CIR
Mailing Address - Street 2:
Mailing Address - City:GLEN MILLS
Mailing Address - State:PA
Mailing Address - Zip Code:19342-1294
Mailing Address - Country:US
Mailing Address - Phone:610-687-1257
Mailing Address - Fax:
Practice Address - Street 1:330 CHRISTIANA MEDICAL CTR
Practice Address - Street 2:
Practice Address - City:NEWARK
Practice Address - State:DE
Practice Address - Zip Code:19702-1653
Practice Address - Country:US
Practice Address - Phone:302-369-3200
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-05
Last Update Date:2023-11-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PADS-0356681223G0001X
DEG1-0001367122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist
No1223G0001XDental ProvidersDentistGeneral Practice