MEDICARE: DR. COREY SCOTT DDS

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	122300000X	Dentist	17721	MD
2	390200000X	Student in an Organized Health Care Education/Training Program
3	1223G0001X	General Practice Dentistry	13014	NC

General Provider Information

NPI Number	:	1285246058
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. COREY SCOTT DDS

Provider Business Mailing Address
First Line	:	2456 MOSTELLER ESTATE AVE SE
Second Line	:
City	:	HICKORY
State	:	NC
Zip	:	28602-3409
Country	:	US
Telephone Number	:	864-617-9016
Fax Number	:

Provider Business Practice Location Address
First Line	:	2290 US HIGHWAY 70 SE # 967A
Second Line	:
City	:	HICKORY
State	:	NC
Zip	:	28602-5164
Country	:	US
Telephone Number	:	864-617-9016
Fax Number	:

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

Provider Enumeration Date	:	08/21/2020
Last Update Date	:	12/19/2023

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