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General NPI Number Information
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NPI Number | 1487035580
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Entity Type | Individual
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Provider Name | SCOTT ANTONIO D.M.D.
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Gender | Male
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Dates
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Enumeration Date | 06/15/2015
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Last Update Date | 02/15/2023
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Provider Practice Location Address
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Address Line | 151 W AIRPORT BLVD
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City | PENSACOLA
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State | FL
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Zip | 32505-2245
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Country | US
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Telephone | 850-477-5252
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Fax | 850-477-5532
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Provider Business Mailing Address
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Address Line | 151 W AIRPORT BLVD
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City | PENSACOLA
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State | FL
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Zip | 32505-2245
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Country | US
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Telephone | 239-218-9614
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Fax | 850-477-5532
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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 | 1223G0001X
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Taxonomy Name | General Practice Dentistry
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License Number | 8542
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License Number State | SC
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Taxonomy #2
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Taxonomy Code | 122300000X
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Taxonomy Name | Dentist
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License Number | DN21199
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License Number State | FL
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