Individual
TIMOTHY BRIAN SCOTT
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
716 W SOUTH ST, BENTON, AR 72015-4160
(501) 778-8201
(501) 778-2841
Mailing address
716 W SOUTH ST, BENTON, AR 72015-4160
(501) 778-8201
(501) 778-2841
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
3247
AR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
134921608
—
AR
01
—
5T783
BLUE CROSS BLUE SHIELD
AR
Enumeration date
07/27/2006
Last updated
07/09/2007
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