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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