Individual
DR. CHARLES F. SCANLON II
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.D.S., MSD
Contact information
Practice address
5955 SOUTH HIGHWAY 16, SUITE A, RAPID CITY, SD 57701-8911
(605) 721-1111
Mailing address
5955 SOUTH HIGHWAY 16, SUITE A, RAPID CITY, SD 57701-8911
(605) 721-1111
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
4492
SC
1223P0300X
Periodontics
Primary
D0968
SD
Other
Enumeration date
09/17/2008
Last updated
04/17/2013
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