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Individual

MARC H SCOLES

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
DMD

Contact information

Practice address
416 NEW LONDON TPKE, GLASTONBURY, CT 06033-2237
(860) 633-3671
(860) 633-9128
Mailing address
416 NEW LONDON TPKE, GLASTONBURY, CT 06033-2237
(860) 633-3671
(860) 633-9128

Taxonomy

Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
4892
CT

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
020004892CT01
ANTHEM BCBS
CT
05
2048924
CT
Enumeration date
03/08/2007
Last updated
07/08/2007
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