Individual
OCTAVIUS BERNARD SCOTT
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
RDH
Contact information
Practice address
4300 DURAFORM LN, WINDSOR, WI 53598-9671
(877) 837-1918
Mailing address
109 BUGLE CALL DR, RAEFORD, NC 28376-7930
(229) 400-1796
Taxonomy
Speciality
Code
Description
License number
State
124Q00000X
Dental Hygienist
Primary
14310
NC
Other
Enumeration date
07/10/2024
Last updated
07/10/2024
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