MEDICARE: MR. STANLEY S SCOTT D.D.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	1223G0001X	General Practice Dentistry	12620	MO

General Provider Information

NPI Number	:	1497026694
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MR. STANLEY S SCOTT D.D.S

Provider Business Mailing Address
First Line	:	7312 TROOST AVE
Second Line	:
City	:	KANSAS CITY
State	:	MO
Zip	:	64131-1746
Country	:	US
Telephone Number	:	816-523-0024
Fax Number	:

Provider Business Practice Location Address
First Line	:	7312 TROOST AVE
Second Line	:
City	:	KANSAS CITY
State	:	MO
Zip	:	64131-1746
Country	:	US
Telephone Number	:	816-523-0024
Fax Number	:

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

Provider Enumeration Date	:	01/19/2012
Last Update Date	:	01/19/2012

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