Individual
DR. SCOTT T ODOM
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.D.S.
Contact information
Practice address
1315 SURREY ST, LAFAYETTE, LA 70501-7617
(337) 593-9989
Mailing address
1315 SURREY ST, LAFAYETTE, LA 70501-7617
(337) 593-9989
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
4901
LA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1849014
—
LA
Enumeration date
03/13/2007
Last updated
07/09/2007
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