Provider Demographics
NPI:1063632735
Name:DRURY, SCOT D (DDS)
Entity type:Individual
Prefix:DR
First Name:SCOT
Middle Name:D
Last Name:DRURY
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1400 FOOTHILL DR
Mailing Address - Street 2:SUITE B38
Mailing Address - City:SALT LAKE CITY
Mailing Address - State:UT
Mailing Address - Zip Code:84108-2327
Mailing Address - Country:US
Mailing Address - Phone:801-582-9351
Mailing Address - Fax:801-582-9350
Practice Address - Street 1:1400 FOOTHILL DR
Practice Address - Street 2:SUITE B38
Practice Address - City:SALT LAKE CITY
Practice Address - State:UT
Practice Address - Zip Code:84108-2327
Practice Address - Country:US
Practice Address - Phone:801-582-9351
Practice Address - Fax:801-582-9350
Is Sole Proprietor?:No
Enumeration Date:2007-04-26
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT142848-99221223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice