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General NPI Number Information
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NPI Number | 1487834438
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Entity Type | Individual
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Provider Name | SCOTT LEWIS SIEGEL DMD
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Gender | Male
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Dates
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Enumeration Date | 11/07/2007
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Last Update Date | 07/09/2024
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Provider Practice Location Address
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Address Line | 5867 N MESA ST STE B
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City | EL PASO
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State | TX
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Zip | 79912-4678
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Country | US
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Telephone | 915-504-6888
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Fax |
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Provider Business Mailing Address
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Address Line | 8713 SEVANO CIR NE
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City | ALBUQUERQUE
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State | NM
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Zip | 87113-2494
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Country | US
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Telephone | 512-787-7174
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Fax | 505-916-0169
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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 | 1223D0004X
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Taxonomy Name | Dental Anesthesiology
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License Number | DD2955
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License Number State | NM
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Taxonomy #2
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Taxonomy Code | 1223D0004X
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Taxonomy Name | Dental Anesthesiology
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License Number | 24336
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License Number State | TX
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