Organization
BRIAN SCOTT, LLC
Active
Other names
Advanced Dental Specialty Group
Organization subpart
No
Provider details
NPI number
Authorized official
SHANNON BIRD (OFFICE MANAGER)
(801) 923-1011
Entity
Organization
Contact information
Practice address
1838 N 1075 W # 100, FARMINGTON, UT 84025-2980
(801) 923-1011
(801) 923-1022
Mailing address
1838 N 1075 W # 100, FARMINGTON, UT 84025-2980
(801) 923-1011
Taxonomy
Speciality
Code
Description
License number
State
1223P0300X
Periodontics
Primary
—
—
1223X0400X
Orthodontics and Dentofacial Orthopedics Dentistry
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
272251
LICENSE
—
Enumeration date
04/07/2021
Last updated
04/28/2021
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