MEDICARE: DR. DONALD SCOTT NAVARRO D.D.S.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	1223D0001X	Public Health Dentistry	2901009775	MI

General Provider Information

NPI Number	:	1063417244
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. DONALD SCOTT NAVARRO D.D.S.

Provider Business Mailing Address
First Line	:	74 WEDGEWOOD DR
Second Line	:
City	:	MONTVILLE
State	:	NJ
Zip	:	07045-9044
Country	:	US
Telephone Number	:	973-285-4062
Fax Number	:	973-285-4140

Provider Business Practice Location Address
First Line	:	74 WEDGEWOOD DR
Second Line	:
City	:	MONTVILLE
State	:	NJ
Zip	:	07045-9044
Country	:	US
Telephone Number	:	973-285-4062
Fax Number	:	973-285-4140

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/15/2005
Last Update Date	:	07/08/2007

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