Healthcare Provider Details
I. General information
NPI: 1427123785
Provider Name (Legal Business Name): SCOTT A DEMPSEY DDS
Entity Type: Individual
Gender: Male
Sole Proprietor: N
II. Dates (important events)
Enumeration Date: 11/22/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
103 NE DOUGLAS STREET
LEES SUMMIT MO
64063-2037
US
IV. Provider business mailing address
103 NE DOUGLAS STREET
LEES SUMMIT MO
64063-2037
US
V. Phone/Fax
- Phone: 816-524-1337
- Fax: 816-525-7640
- Phone: 816-524-1337
- Fax: 816-525-7640
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 1223G0001X |
| Taxonomy | General Practice Dentistry |
| License Number | DE015418 |
| License Number State | MO |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: