MEDICARE: DR. SCOTT COLMAN D.D.S.

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	122300000X	Dentist	35873	NY
2	1223G0001X	General Practice Dentistry	6480	CT

General Provider Information

NPI Number	:	1982792800
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. SCOTT COLMAN D.D.S.

Provider Business Mailing Address
First Line	:	106 SULLIVAN FARM
Second Line	:
City	:	NEW MILFORD
State	:	CT
Zip	:	06776-4572
Country	:	US
Telephone Number	:	914-374-0562
Fax Number	:	203-900-8708

Provider Business Practice Location Address
First Line	:	120 MAIN ST
Second Line	:
City	:	DANBURY
State	:	CT
Zip	:	06810-7834
Country	:	US
Telephone Number	:	203-456-1408
Fax Number	:

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

Provider Enumeration Date	:	10/10/2006
Last Update Date	:	12/28/2023

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