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NPI Code Detail

MEDICARE: DR. SCOTT MICHAEL KEILTY DMD

MEDICARE: DR. SCOTT MICHAEL KEILTY 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 Dentistry7500CT

General Provider Information

NPI Number : 1942349576
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. SCOTT MICHAEL KEILTY DMD
Provider Business Mailing Address
First Line : 20 S ANGUILLA RD
Second Line : SUITE 1
City : PAWCATUCK
State : CT
Zip : 06379-1447
Country : US
Telephone Number : 860-599-2505
Fax Number :
Provider Business Practice Location Address
First Line : 20 S ANGUILLA RD
Second Line : SUITE 1
City : PAWCATUCK
State : CT
Zip : 06379-1447
Country : US
Telephone Number : 860-599-2505
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 02/06/2007
Last Update Date : 07/08/2007

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Directions to “ DR. SCOTT MICHAEL KEILTY DMD” Practice Location

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