Provider Demographics
NPI:1427237296
Name:HOOD, SCOTT C (DDS , PC)
Entity type:Individual
Prefix:
First Name:SCOTT
Middle Name:C
Last Name:HOOD
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 1:127 S MAIN ST
Mailing Address - Street 2:
Mailing Address - City:ADRIAN
Mailing Address - State:MI
Mailing Address - Zip Code:49221-2623
Mailing Address - Country:US
Mailing Address - Phone:517-265-6939
Mailing Address - Fax:517-265-3083
Practice Address - Street 1:127 S MAIN ST
Practice Address - Street 2:
Practice Address - City:ADRIAN
Practice Address - State:MI
Practice Address - Zip Code:49221-2623
Practice Address - Country:US
Practice Address - Phone:517-265-6939
Practice Address - Fax:517-265-3083
Is Sole Proprietor?:Yes
Enumeration Date:2007-10-30
Last Update Date:2014-07-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI17442122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI9119546700Medicaid