MEDICARE: DR. SCOTT ALLISON BROWN 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	4052	LA

General Provider Information

NPI Number	:	1780736835
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. SCOTT ALLISON BROWN D.D.S.

Provider Business Mailing Address
First Line	:	1326 HIGHWAY 80 E
Second Line	:
City	:	CALHOUN
State	:	LA
Zip	:	71225-9113
Country	:	US
Telephone Number	:	318-644-5948
Fax Number	:	318-644-5948

Provider Business Practice Location Address
First Line	:	1326 HIGHWAY 80 E
Second Line	:
City	:	CALHOUN
State	:	LA
Zip	:	71225-9113
Country	:	US
Telephone Number	:	318-644-5948
Fax Number	:	318-644-5948

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

Provider Enumeration Date	:	01/17/2007
Last Update Date	:	07/08/2007

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