Provider Demographics
NPI:1033557780
Name:THEWS, SCOTT G (DDS)
Entity Type:Individual
Prefix:DR
First Name:SCOTT
Middle Name:G
Last Name:THEWS
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2611 PROMENADE PKWY
Mailing Address - Street 2:
Mailing Address - City:MIDLOTHIAN
Mailing Address - State:VA
Mailing Address - Zip Code:23113-1431
Mailing Address - Country:US
Mailing Address - Phone:804-794-6900
Mailing Address - Fax:804-794-7974
Practice Address - Street 1:2611 PROMENADE PKWY
Practice Address - Street 2:
Practice Address - City:MIDLOTHIAN
Practice Address - State:VA
Practice Address - Zip Code:23113-1431
Practice Address - Country:US
Practice Address - Phone:804-794-6900
Practice Address - Fax:804-794-7974
Is Sole Proprietor?:Yes
Enumeration Date:2013-06-04
Last Update Date:2013-06-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA04014110771223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice