Individual
MRS. MONA LISA SCOTT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RDA
Contact information
Practice address
600 RAYDER AVE, LOUDON, TN 37774-1050
(465) 458-2662
Mailing address
140 EASTWOOD DR, SWEETWATER, TN 37874-6246
(423) 337-8246
Taxonomy
Speciality
Code
Description
License number
State
126800000X
Dental Assistant
Primary
10611
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
10611
REGISTERED DENTAL ASSISTA
TN
Enumeration date
01/26/2007
Last updated
07/08/2007
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