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General NPI Number Information
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NPI Number | 1902085921
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Entity Type | Organization
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Legal Business Name | SCOTT AN, DDS,INC.
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Dates
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Enumeration Date | 10/26/2007
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Last Update Date | 10/26/2007
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Provider Practice Location Address
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Address Line | 10715 S PRAIRIE AVE
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City | INGLEWOOD
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State | CA
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Zip | 90303-2113
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Country | US
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Telephone | 310-419-6463
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Fax |
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Provider Business Mailing Address
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Address Line | 818 S ARDMORE AVE
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City | LOS ANGELES
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State | CA
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Zip | 90005-2410
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Country | US
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Telephone | 213-804-5220
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | SCOTT AN
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Credential | DDS
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Telephone | 310-419-6463
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QD0000X
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Taxonomy Name | Dental Clinic/Center
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License Number | 48700
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License Number State | CA
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