MEDICARE: DR. SCOTT A EHLERS DMD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	122300000X	Dentist	DN20221	FL

General Provider Information

NPI Number	:	1538500749
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. SCOTT A EHLERS DMD

Provider Business Mailing Address
First Line	:	1239 SW 26TH AVE
Second Line	:
City	:	POMPANO BEACH
State	:	FL
Zip	:	33069-4311
Country	:	US
Telephone Number	:	954-974-2140
Fax Number	:	954-974-5204

Provider Business Practice Location Address
First Line	:	1239 SW 26TH AVE
Second Line	:
City	:	POMPANO BEACH
State	:	FL
Zip	:	33069-4311
Country	:	US
Telephone Number	:	954-974-2140
Fax Number	:	954-974-5204

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	07/16/2013
Last Update Date	:	07/16/2013

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