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Organization

SCOTT F TUCKER, DDS MS PA

Active
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Organization

SCOTT F TUCKER, DDS MS PA

Active
Other names
University Dental Associates Pediatrics, University Dental Associates
Organization subpart
No

Provider details

NPI number
Authorized official
HILLARY THULL (SENIOR CREDENTIALING COORDINATOR)
(217) 540-8946
Entity
Organization

Contact information

Practice address
2231 CLOVERDALE AVE, WINSTON SALEM, NC 27103-2301
(704) 547-1970
(704) 547-1926
Mailing address
PO BOX 505117, SAINT LOUIS, MO 63150-5117
(781) 213-3336
(781) 224-4216

Taxonomy

Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
—
—

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
—
8993101
—
NC
Enumeration date
11/29/2006
Last updated
09/02/2026
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