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General NPI Number Information
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NPI Number | 1578827176
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Entity Type | Organization
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Legal Business Name | SCOTT N SANTOS DDS PC
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Dates
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Enumeration Date | 06/27/2012
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Last Update Date | 06/27/2012
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Provider Practice Location Address
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Address Line | 427 S HOLLADAY DR
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City | SEASIDE
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State | OR
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Zip | 97138-6729
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Country | US
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Telephone | 503-738-6733
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Fax | 503-738-7617
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Provider Business Mailing Address
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Address Line | 427 S HOLLADAY DR
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City | SEASIDE
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State | OR
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Zip | 97138-6729
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Country | US
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Telephone | 503-738-6733
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Fax | 503-738-7617
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Authorized Official
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Title or Position | OWNER
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Name | DR. SCOTT N SANTOS
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Credential | DDS
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Telephone | 503-738-6733
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QD0000X
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Taxonomy Name | Dental Clinic/Center
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License Number | D8236
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License Number State | OR
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