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General NPI Number Information
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NPI Number | 1730490434
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Entity Type | Individual
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Provider Name | KYLE STEVEN SCOTT D.D.S.
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Gender | Male
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Dates
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Enumeration Date | 06/28/2010
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Last Update Date | 07/25/2013
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Provider Practice Location Address
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Address Line | 1455 E GUADALUPE RD STE 1
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City | TEMPE
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State | AZ
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Zip | 85283-3951
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Country | US
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Telephone | 480-831-6440
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Fax |
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Provider Business Mailing Address
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Address Line | 3499 E MELODY LN
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City | GILBERT
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State | AZ
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Zip | 85234-1729
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Country | US
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Telephone | 480-707-3667
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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 | 122300000X
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Taxonomy Name | Dentist
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License Number | 8674
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License Number State | AZ
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Taxonomy #2
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Taxonomy Code | 122300000X
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Taxonomy Name | Dentist
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License Number | 59543
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License Number State | CA
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