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General NPI Number Information
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NPI Number | 1487708061
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Entity Type | Organization
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Legal Business Name | SCOTT D. WINGARD, DMD, PC
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Dates
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Enumeration Date | 01/22/2007
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Last Update Date | 10/21/2010
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Provider Practice Location Address
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Address Line | 1450 ANTHONY RD
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City | AUGUSTA
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State | GA
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Zip | 30904-4794
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Country | US
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Telephone | 706-738-4723
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Fax | 706-738-0128
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Provider Business Mailing Address
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Address Line | 1450 ANTHONY RD
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City | AUGUSTA
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State | GA
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Zip | 30904-4794
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Country | US
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Telephone | 706-738-4723
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Fax | 706-738-0128
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Authorized Official
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Title or Position | OWNER - PRESIDENT
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Name | SCOTT DOUGLAS WINGARD
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Credential | DMD
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Telephone | 706-738-4723
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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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