MEDICARE: DR. DOUGLAS M SCARBORO 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	3765	NC

General Provider Information

NPI Number	:	1528206307
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. DOUGLAS M SCARBORO D.D.S.

Provider Business Mailing Address
First Line	:	PO BOX 227
Second Line	:
City	:	NEWTON GROVE
State	:	NC
Zip	:	28366-0227
Country	:	US
Telephone Number	:	910-567-2646
Fax Number	:	910-567-4847

Provider Business Practice Location Address
First Line	:	1508 MAPLE GROVE CHURCH RD
Second Line	:
City	:	DUNN
State	:	NC
Zip	:	28334-7688
Country	:	US
Telephone Number	:	910-567-2646
Fax Number	:	910-567-4847

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

Provider Enumeration Date	:	02/02/2009
Last Update Date	:	02/02/2009

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