Provider Demographics
NPI:1699289405
Name:SCOTT, LAYLA LAWAHN (RDH)
Entity type:Individual
Prefix:
First Name:LAYLA
Middle Name:LAWAHN
Last Name:SCOTT
Suffix:
Gender:F
Credentials:RDH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4 KEITH WAY STE 3
Mailing Address - Street 2:
Mailing Address - City:HINGHAM
Mailing Address - State:MA
Mailing Address - Zip Code:02043-4258
Mailing Address - Country:US
Mailing Address - Phone:781-267-7627
Mailing Address - Fax:
Practice Address - Street 1:4 KEITH WAY STE 3
Practice Address - Street 2:
Practice Address - City:HINGHAM
Practice Address - State:MA
Practice Address - Zip Code:02043-4258
Practice Address - Country:US
Practice Address - Phone:781-267-7627
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-12-01
Last Update Date:2017-12-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MADH87137124Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes124Q00000XDental ProvidersDental Hygienist