Individual
SCOT E BREWER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DMD
Contact information
Practice address
1208 E JEFFERY DR, MAHOMET, IL 61853-2750
(217) 841-3035
Mailing address
1208 E JEFFERY DR, MAHOMET, IL 61853-2750
(217) 841-3035
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
019018558
IL
1223G0001X
General Practice Dentistry
019018558
IL
Other
Enumeration date
01/14/2008
Last updated
01/02/2012
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