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General NPI Number Information
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NPI Number | 1164701124
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Entity Type | Organization
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Legal Business Name | SCOTT M HEALEY DMD
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Dates
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Enumeration Date | 08/09/2011
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Last Update Date | 08/09/2011
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Provider Practice Location Address
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Address Line | 530 N STATE ST
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City | LINDON
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State | UT
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Zip | 84042-1321
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Country | US
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Telephone | 801-785-0584
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Fax | 801-785-0586
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Provider Business Mailing Address
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Address Line | 530 N STATE ST
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City | LINDON
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State | UT
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Zip | 84042-1321
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Country | US
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Telephone | 801-785-0584
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Fax | 801-785-0586
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Authorized Official
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Title or Position | PRESIDENT
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Name | SCOTT M HEALEY
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Credential | D.M.D
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Telephone | 801-785-0584
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 122300000X
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Taxonomy Name | Dentist
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License Number | 139600-9922
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License Number State | UT
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