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General NPI Number Information
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NPI Number | 1750470860
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Entity Type | Organization
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Legal Business Name | SCOTT L. MCDONALD D.D.S., INC.
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Dates
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Enumeration Date | 10/12/2006
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Last Update Date | 09/28/2007
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Provider Practice Location Address
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Address Line | 301 EAST AVE
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City | ELYRIA
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State | OH
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Zip | 44035-5736
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Country | US
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Telephone | 440-322-2027
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Fax |
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Provider Business Mailing Address
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Address Line | 301 EAST AVE
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City | ELYRIA
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State | OH
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Zip | 44035-5736
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. SCOTT L. MCDONALD
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Credential |
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Telephone | 440-322-2027
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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 | 17387
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License Number State | OH
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