Individual
SCOTT PERKINS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
465 MEMORIAL DR, POCATELLO, ID 83201-4008
(208) 282-6000
Mailing address
4170 HAWTHORNE RD APT C306, CHUBBUCK, ID 83202-2891
(612) 750-0107
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
D-5268
ID
Other
Enumeration date
06/25/2021
Last updated
06/25/2021
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