Healthcare Provider Details

I. General information

NPI: 1679576334
Provider Name (Legal Business Name): SCOTT T ROWLEY DMD, MSD
Entity Type: Individual
Gender: Male
Sole Proprietor: X

II. Dates (important events)

Enumeration Date: 05/24/2005
Last Update Date: 07/09/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

615 N F ST
ABERDEEN WA
98520-2657
US

IV. Provider business mailing address

615 N F ST
ABERDEEN WA
98520-2657
US

V. Phone/Fax

Practice location:
  • Phone: 360-533-8846
  • Fax: 360-533-7446
Mailing address:
  • Phone: 360-533-8846
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223P0221X
TaxonomyPediatric Dentistry
License NumberDE00009180
License Number StateWA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: