Provider Demographics
NPI:1386798783
Name:SCOTT, JAMES BEN (DDS PC)
Entity type:Individual
Prefix:DR
First Name:JAMES
Middle Name:BEN
Last Name:SCOTT
Suffix:
Gender:M
Credentials:DDS PC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:418 WEST BROADWAY
Mailing Address - Street 2:
Mailing Address - City:LEWISTOWN
Mailing Address - State:MT
Mailing Address - Zip Code:59457
Mailing Address - Country:US
Mailing Address - Phone:406-538-5388
Mailing Address - Fax:406-538-5388
Practice Address - Street 1:418 WEST BROADWAY
Practice Address - Street 2:
Practice Address - City:LEWISTOWN
Practice Address - State:MT
Practice Address - Zip Code:59457
Practice Address - Country:US
Practice Address - Phone:406-538-5388
Practice Address - Fax:406-538-5388
Is Sole Proprietor?:No
Enumeration Date:2007-01-22
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MT21181223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice
Provider Identifiers
StateIdentifier IDID TypeIssuer
MT0113033Medicaid
MT21184OtherBXBLUESHIELD OF MT
MT5512403OtherCHIPS