Provider Demographics
NPI:1528117710
Name:DUFF, SCOTT G (DMD)
Entity type:Individual
Prefix:DR
First Name:SCOTT
Middle Name:G
Last Name:DUFF
Suffix:
Gender:M
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:254 EDENBERRY AVE
Mailing Address - Street 2:
Mailing Address - City:JUPITER
Mailing Address - State:FL
Mailing Address - Zip Code:33458-6520
Mailing Address - Country:US
Mailing Address - Phone:561-775-0258
Mailing Address - Fax:
Practice Address - Street 1:254 EDENBERRY AVE
Practice Address - Street 2:
Practice Address - City:JUPITER
Practice Address - State:FL
Practice Address - Zip Code:33458-6520
Practice Address - Country:US
Practice Address - Phone:561-881-0067
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-09
Last Update Date:2019-08-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLDN114411223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice