MEDICARE: DR. SCOTT MASLOW 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
1	1223G0001X	General Practice Dentistry	12756	NJ

General Provider Information

NPI Number	:	1831271659
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. SCOTT MASLOW DMD

Provider Business Mailing Address
First Line	:	9850 PACIFIC AVE
Second Line	:
City	:	WILDWOOD CREST
State	:	NJ
Zip	:	08260-3213
Country	:	US
Telephone Number	:	609-522-3145
Fax Number	:	609-522-9008

Provider Business Practice Location Address
First Line	:	9850 PACIFIC AVE
Second Line	:
City	:	WILDWOOD CREST
State	:	NJ
Zip	:	08260-3213
Country	:	US
Telephone Number	:	609-522-3145
Fax Number	:	609-522-9008

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

Provider Enumeration Date	:	10/20/2006
Last Update Date	:	07/08/2007

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