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NPI 1548298144

NPI 1548298144 : SCOTT DARREN MCELROY DDS : SAN RAMON, CA

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General NPI Number Information
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    NPI Number           |    1548298144
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    Entity Type          |    Individual 
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    Provider Name        |    SCOTT DARREN MCELROY DDS
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    Gender               |    Male 
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Dates
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    Enumeration Date     |    06/30/2006
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    Last Update Date     |    07/08/2007
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Provider Practice Location Address
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    Address Line         |    2301 CAMINO RAMON STE 288
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    City                 |    SAN RAMON
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    State                |    CA
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    Zip                  |    94583-4440
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    Country              |    US
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    Telephone            |    925-242-0180
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    Fax                  |    925-242-0181
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Provider Business Mailing Address
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    Address Line         |    5122 DAMIANO CT 
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    City                 |    PLEASANTON
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    State                |    CA
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    Zip                  |    94588-4135
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    Country              |    US
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    Telephone            |    925-469-9620
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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        |    1223X0400X
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    Taxonomy Name        |    Orthodontics and Dentofacial Orthopedics Dentistry
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    License Number       |    42744
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    License Number State |    CA
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