Provider Demographics
NPI:1124041991
Name:SCOTTI, JOSEPH CHARLES (DMD)
Entity type:Individual
Prefix:DR
First Name:JOSEPH
Middle Name:CHARLES
Last Name:SCOTTI
Suffix:
Gender:M
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1130 PELHAM PKWY S
Mailing Address - Street 2:APT. 1-D
Mailing Address - City:BRONX
Mailing Address - State:NY
Mailing Address - Zip Code:10461-1019
Mailing Address - Country:US
Mailing Address - Phone:718-824-4666
Mailing Address - Fax:
Practice Address - Street 1:1130 PELHAM PKWY S
Practice Address - Street 2:APT. 1-D
Practice Address - City:BRONX
Practice Address - State:NY
Practice Address - Zip Code:10461-1019
Practice Address - Country:US
Practice Address - Phone:718-824-4666
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-25
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY316711223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice