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General NPI Number Information
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NPI Number | 1184748717
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Entity Type | Individual
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Provider Name | SCOTT V. WELLMAN DDS
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Gender | Male
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Dates
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Enumeration Date | 03/19/2007
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Last Update Date | 12/06/2013
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Provider Practice Location Address
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Address Line | 101 R L SAWYER MD DR
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City | SALUDA
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State | SC
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Zip | 29138-9199
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Country | US
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Telephone | 864-445-8168
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Fax |
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Provider Business Mailing Address
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Address Line | 305 TISBURY CT
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City | LEXINGTON
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State | SC
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Zip | 29072-7748
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Country | US
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Telephone | 623-910-0407
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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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 | 8210
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License Number State | SC
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Taxonomy #2
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Taxonomy Code | 1223G0001X
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Taxonomy Name | General Practice Dentistry
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License Number | D6948
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License Number State | AZ
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