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General NPI Number Information
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NPI Number | 1447249313
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Entity Type | Individual
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Provider Name | SCOTT ARTHUR MACKEY DDS
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Gender | Male
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Dates
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Enumeration Date | 10/13/2005
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Last Update Date | 09/13/2023
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Provider Practice Location Address
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Address Line | VA NORTHEAST OHIO HEALTH CARE SYSTEM 10701 EAST BLVD
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City | CLEVELAND
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State | OH
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Zip | 44106
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Country | US
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Telephone | 216-791-3800
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Fax |
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Provider Business Mailing Address
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Address Line | VA NORTHEAST OHIO HEALTH CARE SYSTEM 10701 EAST BLVD
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City | CLEVELAND
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State | OH
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Zip | 44106
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Country | US
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Telephone | 216-791-3800
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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 | 1223P0300X
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Taxonomy Name | Periodontics
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License Number | 30-01-9580
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License Number State | OH
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