Organization
SCOTT DENTAL GROUP L L C
Active
Other names
Scott Dental Group L L C
Organization subpart
No
Provider details
NPI number
Authorized official
DR. DARREL L SCOTT DDS (OWNER)
(419) 994-3111
Entity
Organization
Contact information
Practice address
633 N UNION ST, LOUDONVILLE, OH 44842-1074
(419) 994-3111
(419) 994-4078
Mailing address
633 N UNION ST, LOUDONVILLE, OH 44842-1074
(419) 994-3111
(419) 994-4078
Taxonomy
Speciality
Code
Description
License number
State
261QD0000X
Dental Clinic/Center
Primary
16373
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0436611
—
OH
05
—
2969097
—
OH
Enumeration date
08/18/2010
Last updated
08/18/2010
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