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General NPI Number Information
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NPI Number | 1235740366
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Entity Type | Individual
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Provider Name | SCOTT ANDREW ADUDDELL DDS
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Gender | Male
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Dates
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Enumeration Date | 08/12/2020
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Last Update Date | 08/12/2020
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Provider Practice Location Address
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Address Line | 1300 MEDICAL AVE STE 101
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City | PLANO
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State | TX
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Zip | 75075-7798
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Country | US
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Telephone | 972-867-5544
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Fax | 972-867-3691
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Provider Business Mailing Address
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Address Line | 1300 MEDICAL AVE
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City | PLANO
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State | TX
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Zip | 75075-7799
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Country | US
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Telephone | 972-867-5544
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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 | 36552
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License Number State | TX
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