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General NPI Number Information
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NPI Number | 1326698713
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Entity Type | Organization
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Legal Business Name | GINGER SCOGGINS D.D.S. I.N.C.
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Dates
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Enumeration Date | 09/17/2019
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Last Update Date | 09/24/2019
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Provider Practice Location Address
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Address Line | 13605 BEAR VALLEY RD STE 105A
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City | VICTORVILLE
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State | CA
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Zip | 92392-6660
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Country | US
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Telephone | 760-244-3112
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Fax | 760-244-7191
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Provider Business Mailing Address
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Address Line | 13605 BEAR VALLEY RD STE 105A
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City | VICTORVILLE
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State | CA
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Zip | 92392-6660
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Country | US
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Telephone | 760-244-3112
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Fax | 760-244-7191
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Authorized Official
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Title or Position | OFFICE MANAGER
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Name | MRS. NICOLE MARIE COBO
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Credential |
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Telephone | 760-244-3112
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1223G0001X
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Taxonomy Name | General Practice Dentistry
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License Number |
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License Number State |
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