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General NPI Number Information
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NPI Number | 1962680066
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Entity Type | Organization
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Legal Business Name | BRYAN M. SCOTT, DDS, INC.
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Dates
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Enumeration Date | 01/31/2008
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Last Update Date | 01/31/2008
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Provider Practice Location Address
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Address Line | 1790 TOWN PARK BLVD SUITE E
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City | UNIONTOWN
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State | OH
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Zip | 44685-7972
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Country | US
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Telephone | 330-899-9001
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Fax | 330-899-9006
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Provider Business Mailing Address
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Address Line | 1790 TOWN PARK BLVD SUITE E
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City | UNIONTOWN
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State | OH
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Zip | 44685-7972
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Country | US
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Telephone | 330-899-9001
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Fax | 330-899-9006
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. BRYAN MICHAEL SCOTT
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Credential | D.D.S.
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Telephone | 330-899-9001
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1223S0112X
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Taxonomy Name | Oral and Maxillofacial Surgery (Dentist)
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License Number | 30-020984
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License Number State | OH
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