Provider Demographics
NPI:1336983832
Name:SCOTT DENTAL CONSULTANTS PLLC
Entity type:Organization
Organization Name:SCOTT DENTAL CONSULTANTS PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:KEVIN
Authorized Official - Middle Name:
Authorized Official - Last Name:SCOTT
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:210-705-3111
Mailing Address - Street 1:750 FISH CREEK THOROUGHFARE STE 260
Mailing Address - Street 2:
Mailing Address - City:MONTGOMERY
Mailing Address - State:TX
Mailing Address - Zip Code:77316-6966
Mailing Address - Country:US
Mailing Address - Phone:210-705-3111
Mailing Address - Fax:
Practice Address - Street 1:750 FISH CREEK THOROUGHFARE STE 260
Practice Address - Street 2:
Practice Address - City:MONTGOMERY
Practice Address - State:TX
Practice Address - Zip Code:77316-6966
Practice Address - Country:US
Practice Address - Phone:210-705-3111
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-06-20
Last Update Date:2024-06-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QD0000XAmbulatory Health Care FacilitiesClinic/CenterDental
No332BC3200XSuppliersDurable Medical Equipment & Medical SuppliesCustomized Equipment