Provider Demographics
NPI:1194877597
Name:NAGEL, SCOTT (DMD)
Entity type:Individual
Prefix:
First Name:SCOTT
Middle Name:
Last Name:NAGEL
Suffix:
Gender:M
Credentials:DMD
Other - Prefix:
Other - First Name:SCOTT
Other - Middle Name:
Other - Last Name:NAGEL
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:DMD
Mailing Address - Street 1:4893 RIVER HILLS DR
Mailing Address - Street 2:
Mailing Address - City:DENVER
Mailing Address - State:NC
Mailing Address - Zip Code:28037-8498
Mailing Address - Country:US
Mailing Address - Phone:704-308-0586
Mailing Address - Fax:
Practice Address - Street 1:4893 RIVER HILLS DR
Practice Address - Street 2:
Practice Address - City:DENVER
Practice Address - State:NC
Practice Address - Zip Code:28037-8498
Practice Address - Country:US
Practice Address - Phone:704-308-0586
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-17
Last Update Date:2009-09-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PADS028549L1223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice