MEDICARE: DR. SCOTT J. CEFALU

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	5176	LA

General Provider Information

NPI Number	:	1912109323
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. SCOTT J. CEFALU

Provider Business Mailing Address
First Line	:	5213 W NAPOLEON AVE
Second Line	:
City	:	METAIRIE
State	:	LA
Zip	:	70001-2266
Country	:	US
Telephone Number	:	504-455-2182
Fax Number	:	504-455-3536

Provider Business Practice Location Address
First Line	:	5213 W NAPOLEON AVE
Second Line	:
City	:	METAIRIE
State	:	LA
Zip	:	70001-2266
Country	:	US
Telephone Number	:	504-455-2182
Fax Number	:	504-455-3536

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

Provider Enumeration Date	:	06/05/2007
Last Update Date	:	07/08/2007

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