MEDICARE: DR. SCOTT FRANKLIN TUCKER 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	8188	NC

General Provider Information

NPI Number	:	1902025745
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. SCOTT FRANKLIN TUCKER D.D.S.

Provider Business Mailing Address
First Line	:	2287 CLOVERDALE AVE
Second Line	:
City	:	WINSTON SALEM
State	:	NC
Zip	:	27103-2301
Country	:	US
Telephone Number	:	336-837-2680
Fax Number	:

Provider Business Practice Location Address
First Line	:	2287 CLOVERDALE AVE
Second Line	:
City	:	WINSTON SALEM
State	:	NC
Zip	:	27103-2301
Country	:	US
Telephone Number	:	336-837-2680
Fax Number	:	336-837-2681

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

Provider Enumeration Date	:	04/24/2007
Last Update Date	:	01/19/2026

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