Individual
SAM SCOTT
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
833 ANDERSON AVE, COOS BAY, OR 97420-4641
(542) 267-3447
Mailing address
833 ANDERSON AVE, COOS BAY, OR 97420-4641
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
D6512
OR
Other
Enumeration date
02/20/2007
Last updated
07/08/2007
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