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General NPI Number Information
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NPI Number | 1881214807
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Entity Type | Individual
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Provider Name | SE'QUON M. H. SCOTT
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Gender | Male
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Dates
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Enumeration Date | 04/20/2020
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Last Update Date | 02/16/2025
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Provider Practice Location Address
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Address Line | 4205 N POINT PKWY STE A
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City | ALPHARETTA
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State | GA
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Zip | 30022-8808
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Country | US
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Telephone | 770-502-6208
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Fax |
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Provider Business Mailing Address
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Address Line | 4205 N POINT PKWY STE A
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City | ALPHARETTA
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State | GA
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Zip | 30022-8808
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Country | US
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Telephone | 770-502-6208
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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 | 1223P0300X
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Taxonomy Name | Periodontics
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License Number | 14050
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License Number State | CT
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Taxonomy #2
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Taxonomy Code | 1223P0300X
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Taxonomy Name | Periodontics
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License Number | DN123699
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License Number State | GA
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