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General NPI Number Information
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NPI Number | 1487110813
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Entity Type | Organization
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Legal Business Name | KEVIN SCOTTI DDS
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Dates
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Enumeration Date | 02/11/2019
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Last Update Date | 02/11/2019
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Provider Practice Location Address
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Address Line | 3801 FAIRFAX DR STE 70
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City | ARLINGTON
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State | VA
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Zip | 22203-1762
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Country | US
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Telephone | 703-465-0123
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Fax |
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Provider Business Mailing Address
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Address Line | 520 12TH ST S APT 1805
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City | ARLINGTON
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State | VA
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Zip | 22202-4279
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Country | US
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Telephone | 317-702-0794
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Fax |
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Authorized Official
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Title or Position | PROSTHODONTIST
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Name | DR. KEVIN SCOTTI
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Credential | DDS
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Telephone | 317-702-0794
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QD0000X
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Taxonomy Name | Dental Clinic/Center
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License Number |
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License Number State |
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