Provider Demographics
NPI:1285815597
Name:GREESON, SCOTT S (DDS)
Entity type:Individual
Prefix:DR
First Name:SCOTT
Middle Name:S
Last Name:GREESON
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 1:2947 S BUCKNER BLVD
Mailing Address - Street 2:STE. 100
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75227-6952
Mailing Address - Country:US
Mailing Address - Phone:214-381-3800
Mailing Address - Fax:214-381-4500
Practice Address - Street 1:2947 S BUCKNER BLVD
Practice Address - Street 2:STE. 100
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75227-6952
Practice Address - Country:US
Practice Address - Phone:214-381-3800
Practice Address - Fax:214-381-4500
Is Sole Proprietor?:Yes
Enumeration Date:2007-11-15
Last Update Date:2007-11-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX235431223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice