Healthcare Provider Details

I. General information

NPI: 1356314694
Provider Name (Legal Business Name): SCOTT ALLEN WESTFORD DDS
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/08/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

14818 179TH AVE SE
MONROE WA
98272
US

IV. Provider business mailing address

18927 103RD AVE NE
BOTHELL WA
98011
US

V. Phone/Fax

Practice location:
  • Phone: 360-805-8585
  • Fax: 360-805-1983
Mailing address:
  • Phone: 425-760-9609
  • Fax: 360-805-1983

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223E0200X
TaxonomyEndodontics
License NumberDE00009613
License Number StateWA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: