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Organization
TX-SCD DENTAL PC
Active
Organization
TX-SCD DENTAL PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. SCOTT C DICKINSON DMD (OWNER)
(315) 454-6000
Entity
Organization
Contact information
Practice address
6105 E HIGHWAY 191, ODESSA, TX 79762
(315) 454-6000
Mailing address
PO BOX 3189, SYRACUSE, NY 13220-3189
(315) 454-6000
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
28860
TX
Other
Enumeration date
07/05/2013
Last updated
07/19/2013
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