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General NPI Number Information
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NPI Number | 1972718997
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Entity Type | Individual
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Provider Name | G. SCOTT PRATT DDS
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Gender | Male
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Dates
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Enumeration Date | 05/12/2007
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Last Update Date | 10/22/2008
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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 | 440-322-1725
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Fax |
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Provider Business Mailing Address
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Address Line | 2200 AUGUSTA CT
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City | WESTLAKE
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State | OH
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Zip | 44145-1841
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Country | US
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Telephone | 440-871-1904
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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 | 17820
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License Number State | OH
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