MEDICARE: PATRICIA A SCOTT DDS PA

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	1223S0112X	Oral and Maxillofacial Surgery (Dentist)	DN3008	FL

General Provider Information

NPI Number	:	1083813117
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	PATRICIA A SCOTT DDS PA

Provider Business Mailing Address
First Line	:	3443 TAMIAMI TRL STE A
Second Line	:
City	:	PORT CHARLOTTE
State	:	FL
Zip	:	33952-8159
Country	:	US
Telephone Number	:	941-625-8500
Fax Number	:	941-625-0874

Provider Business Practice Location Address
First Line	:	3443 TAMIAMI TRL STE A
Second Line	:
City	:	PORT CHARLOTTE
State	:	FL
Zip	:	33952-8159
Country	:	US
Telephone Number	:	941-625-8500
Fax Number	:	941-625-0874

Authorized Official
Title or Position	:	ORAL SURGEON
Name	:	DR. PATRICIA A SCOTT
Credential	:	DDS PA
Telephone Number	:	941-625-8500

Provider Enumeration Date	:	07/18/2007
Last Update Date	:	07/18/2007

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