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Organization
SCRUGGS DENTAL LLC
Active
Organization
SCRUGGS DENTAL LLC
Active
Other names
Scruggs Family Dentistry
Organization subpart
No
Provider details
NPI number
Authorized official
FAITH GASKINS (DIRECTOR OF CREDENTIALING)
(972) 869-3789
Entity
Organization
Contact information
Practice address
2001 E. 70TH STREET, SUITE 105, SHREVEPORT, LA 71005
(318) 798-2008
Mailing address
2403 LACY LN, CARROLLTON, TX 75006-6514
(972) 869-3789
(972) 590-8809
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
—
—
Other
Enumeration date
11/21/2018
Last updated
11/21/2018
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