MEDICARE: DR. SCOTT BRINTON 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	332B00000X	Durable Medical Equipment & Medical Supplies
2	1223G0001X	General Practice Dentistry	DEN-10184	CO

General Provider Information

NPI Number	:	1699086439
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. SCOTT BRINTON D.D.S.

Provider Business Mailing Address
First Line	:	5763 WOLF VILLAGE DR
Second Line	:
City	:	COLORADO SPRINGS
State	:	CO
Zip	:	80924-2002
Country	:	US
Telephone Number	:	719-362-3490
Fax Number	:

Provider Business Practice Location Address
First Line	:	1079 SPACE CENTER DR UNIT 100
Second Line	:
City	:	COLORADO SPRINGS
State	:	CO
Zip	:	80915-3612
Country	:	US
Telephone Number	:	719-574-2211
Fax Number	:

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

Provider Enumeration Date	:	06/26/2010
Last Update Date	:	06/19/2019

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