Individual
DR. CARL RICHARD SCRUGGS JR.
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
37 N MAIN ST, MASSENA, NY 13662-1162
(315) 769-5811
(315) 769-9236
Mailing address
37 N MAIN ST, MASSENA, NY 13662-1162
(315) 769-5811
(315) 769-9236
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
035620
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00706143
—
NY
Enumeration date
10/16/2006
Last updated
07/08/2007
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