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General NPI Number Information
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NPI Number | 1710496278
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Entity Type | Organization
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Legal Business Name | L SCOTT BRODY DDS PC
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Dates
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Enumeration Date | 09/27/2017
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Last Update Date | 07/21/2022
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Provider Practice Location Address
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Address Line | 1025 S PERRY ST STE 105
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City | CASTLE ROCK
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State | CO
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Zip | 80104-3365
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Country | US
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Telephone | 303-688-2229
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Fax |
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Provider Business Mailing Address
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Address Line | 1025 S PERRY ST STE 105
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City | CASTLE ROCK
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State | CO
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Zip | 80104-3365
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Country | US
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Telephone | 303-688-2229
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | DR. LEE SCOTT BRODY
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Credential | DDS
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Telephone | 303-688-2229
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1223D0001X
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Taxonomy Name | Public Health Dentistry
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License Number |
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License Number State |
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