MEDICARE: SCOTT M CAREL DDS PC

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	4812	OK

General Provider Information

NPI Number	:	1518121862
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	SCOTT M CAREL DDS PC

Provider Business Mailing Address
First Line	:	6025 W RENO AVE STE A
Second Line	:
City	:	OKLAHOMA CITY
State	:	OK
Zip	:	73127-6654
Country	:	US
Telephone Number	:	405-789-5300
Fax Number	:	405-789-5305

Provider Business Practice Location Address
First Line	:	6025 W RENO AVE STE A
Second Line	:
City	:	OKLAHOMA CITY
State	:	OK
Zip	:	73127-6654
Country	:	US
Telephone Number	:	405-789-5300
Fax Number	:	405-789-5305

Authorized Official
Title or Position	:	PRESIDENT/DENTIST
Name	:	DR. SCOTT MICHAEL CAREL
Credential	:	MD
Telephone Number	:	405-789-5300

Provider Enumeration Date	:	07/16/2008
Last Update Date	:	07/16/2008

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