MEDICARE: DR. CHARLES SCOTT YOUNG 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	122300000X	Dentist	19834	TX

General Provider Information

NPI Number	:	1740301670
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. CHARLES SCOTT YOUNG D.D.S

Provider Business Mailing Address
First Line	:	6769 LAKE WOODLANDS DR STE G
Second Line	:
City	:	THE WOODLANDS
State	:	TX
Zip	:	77382-2770
Country	:	US
Telephone Number	:	281-367-5559
Fax Number	:	281-465-8737

Provider Business Practice Location Address
First Line	:	6769 LAKE WOODLANDS DR STE G
Second Line	:
City	:	THE WOODLANDS
State	:	TX
Zip	:	77382-2770
Country	:	US
Telephone Number	:	281-367-5559
Fax Number	:	281-465-8737

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

Provider Enumeration Date	:	04/02/2007
Last Update Date	:	07/08/2007

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