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General NPI Number Information
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NPI Number | 1649436312
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Entity Type | Individual
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Provider Name | JUSTIN BYRON SCOTT DMD
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Gender | Male
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Dates
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Enumeration Date | 08/01/2008
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Last Update Date | 12/17/2014
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Provider Practice Location Address
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Address Line | 2285 PEACHTREE RD NE STE 203
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City | ATLANTA
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State | GA
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Zip | 30309-1142
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Country | US
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Telephone | 404-901-4707
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Fax | 404-549-2637
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Provider Business Mailing Address
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Address Line | 2285 PEACHTREE RD NE STE 203
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City | ATLANTA
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State | GA
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Zip | 30309-1142
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Country | US
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Telephone | 404-901-4707
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Fax | 404-549-2637
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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 | DN013787
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License Number State | GA
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