MEDICARE: DR. SCOTT ALLAN DRAPER D.D.S., M.S.

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	1223P0700X	Prosthodontics	8698	CO

General Provider Information

NPI Number	:	1124111406
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. SCOTT ALLAN DRAPER D.D.S., M.S.

Provider Business Mailing Address
First Line	:	3527 OAK MEADOW DR
Second Line	:
City	:	COLORADO SPRINGS
State	:	CO
Zip	:	80920-2404
Country	:	US
Telephone Number	:	719-264-0563
Fax Number	:

Provider Business Practice Location Address
First Line	:	1155 KELLY JOHNSON BLVD
Second Line	:	SUITE 210
City	:	COLORADO SPRINGS
State	:	CO
Zip	:	80920-3932
Country	:	US
Telephone Number	:	719-532-1007
Fax Number	:	719-532-0048

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	10/01/2006
Last Update Date	:	07/08/2007

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