Provider Demographics
NPI:1528112588
Name:SCOTT C. EARP DDS P. A.
Entity type:Organization
Organization Name:SCOTT C. EARP DDS P. A.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:SCOTT
Authorized Official - Middle Name:C
Authorized Official - Last Name:EARP
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:919-832-2575
Mailing Address - Street 1:800 SAINT MARYS ST
Mailing Address - Street 2:SUITE #403
Mailing Address - City:RALEIGH
Mailing Address - State:NC
Mailing Address - Zip Code:27605-1400
Mailing Address - Country:US
Mailing Address - Phone:919-832-2575
Mailing Address - Fax:919-832-6309
Practice Address - Street 1:800 SAINT MARYS ST
Practice Address - Street 2:SUITE #403
Practice Address - City:RALEIGH
Practice Address - State:NC
Practice Address - Zip Code:27605-1400
Practice Address - Country:US
Practice Address - Phone:919-832-2575
Practice Address - Fax:919-832-6309
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-23
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC60271223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC899233Medicare ID - Type Unspecified