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NPI Code Detail

MEDICARE: DR. SCOTT AARON MOGELOF DMD

MEDICARE: DR. SCOTT AARON MOGELOF DMD
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
11223G0001XGeneral Practice Dentistry8939CT

General Provider Information

NPI Number : 1811919319
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. SCOTT AARON MOGELOF DMD
Provider Business Mailing Address
First Line : 2499 MAIN ST
Second Line :
City : STRATFORD
State : CT
Zip : 06615-5843
Country : US
Telephone Number : 203-378-5588
Fax Number :
Provider Business Practice Location Address
First Line : 2499 MAIN ST
Second Line :
City : STRATFORD
State : CT
Zip : 06615-5843
Country : US
Telephone Number : 203-378-5588
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/24/2006
Last Update Date : 07/08/2007

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