Provider Demographics
NPI:1972594513
Name:SCOTT TOMLINSON, D.D.S.,P.C.
Entity type:Organization
Organization Name:SCOTT TOMLINSON, D.D.S.,P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:ANTHONY
Authorized Official - Middle Name:SCOTT
Authorized Official - Last Name:TOMLINSON
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:423-239-9197
Mailing Address - Street 1:PO BOX 6196
Mailing Address - Street 2:
Mailing Address - City:KINGSPORT
Mailing Address - State:TN
Mailing Address - Zip Code:37663-1196
Mailing Address - Country:US
Mailing Address - Phone:423-239-9197
Mailing Address - Fax:423-239-0545
Practice Address - Street 1:116 KENDRICK ST
Practice Address - Street 2:
Practice Address - City:KINGSPORT
Practice Address - State:TN
Practice Address - Zip Code:37663-2033
Practice Address - Country:US
Practice Address - Phone:423-239-9197
Practice Address - Fax:423-239-0545
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-11-02
Last Update Date:2015-04-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN78961223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
ILTN0102OtherJOHN DEERE PROVIDER #
PA1630530OtherUNITED CONCORDIA PROVIDER
PA1417679OtherUNITED CONCORDIA PROVIDER
TN4043613OtherBCBS PROVIDER NUMBER