MEDICARE: GREGORY MELVIN LINSCOTT DDS

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	15178	OH

General Provider Information

NPI Number	:	1871690602
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	GREGORY MELVIN LINSCOTT DDS

Provider Business Mailing Address
First Line	:	50 S COURT ST
Second Line	:	SUITE 1
City	:	ATHENS
State	:	OH
Zip	:	45701-2810
Country	:	US
Telephone Number	:	740-593-7493
Fax Number	:	740-593-0533

Provider Business Practice Location Address
First Line	:	50 S COURT ST
Second Line	:	SUITE 1
City	:	ATHENS
State	:	OH
Zip	:	45701-2810
Country	:	US
Telephone Number	:	740-593-7493
Fax Number	:	740-593-0533

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

Provider Enumeration Date	:	09/20/2006
Last Update Date	:	07/08/2007

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