Provider Demographics
NPI:1154338960
Name:GEORGE, SCOTT C (DDS)
Entity type:Individual
Prefix:
First Name:SCOTT
Middle Name:C
Last Name:GEORGE
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:PO BOX 447
Mailing Address - Street 2:
Mailing Address - City:DARDANELLE
Mailing Address - State:AR
Mailing Address - Zip Code:72834-0447
Mailing Address - Country:US
Mailing Address - Phone:479-229-3891
Mailing Address - Fax:479-229-2264
Practice Address - Street 1:2533 STATE HIGHWAY 22 W
Practice Address - Street 2:
Practice Address - City:DARDANELLE
Practice Address - State:AR
Practice Address - Zip Code:72834-8831
Practice Address - Country:US
Practice Address - Phone:479-229-3891
Practice Address - Fax:479-229-2264
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-02
Last Update Date:2023-12-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AR32331223G0001X, 122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist
No1223G0001XDental ProvidersDentistGeneral Practice