Individual
MICHELLE ANNE SCOTT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DDS
Contact information
Practice address
3401 CIVIC CENTER BLVD, PHILADELPHIA, PA 19104-4319
(215) 590-2208
(267) 425-9553
Mailing address
100 E PENN SQ FL 9, PHILADELPHIA, PA 19107-3377
(267) 425-9538
(267) 425-9553
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
57638
CA
1223X0400X
Orthodontics and Dentofacial Orthopedics Dentistry
30-024366
OH
1223X0400X
Orthodontics and Dentofacial Orthopedics Dentistry
Primary
DS041608
PA
Other
Enumeration date
05/12/2009
Last updated
09/23/2020
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