Individual
DR. EDWARD ROOSEVELT SCOTT II
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.M.D.
Contact information
Practice address
1100 E TENNESSEE ST, SUITE B, TALLAHASSEE, FL 32308-6912
(850) 561-6115
(850) 224-7299
Mailing address
1100 E TENNESSEE ST, SUITE B, TALLAHASSEE, FL 32308-6912
(850) 561-6115
(850) 224-7299
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
8400
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
077143102
—
FL
01
—
100242
TRICARE
FL
01
—
66866
BLUECROSS
FL
Enumeration date
05/02/2007
Last updated
05/09/2016
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