Provider Demographics
NPI:1093725558
Name:BELL, E SCOTT (DMD)
Entity Type:Individual
Prefix:DR
First Name:E
Middle Name:SCOTT
Last Name:BELL
Suffix:
Gender:M
Credentials:DMD
Other - Prefix:DR
Other - First Name:E
Other - Middle Name:SCOTT
Other - Last Name:BELL
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:DMD PL
Mailing Address - Street 1:1301 W EAU GALLIE BLVD
Mailing Address - Street 2:
Mailing Address - City:MELBOURNE
Mailing Address - State:FL
Mailing Address - Zip Code:32935
Mailing Address - Country:US
Mailing Address - Phone:321-259-1949
Mailing Address - Fax:321-259-1926
Practice Address - Street 1:1301 W EAU GALLIE BLVD
Practice Address - Street 2:
Practice Address - City:MELBOURNE
Practice Address - State:FL
Practice Address - Zip Code:32935
Practice Address - Country:US
Practice Address - Phone:321-259-1949
Practice Address - Fax:321-259-1926
Is Sole Proprietor?:No
Enumeration Date:2006-08-08
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLFL10444122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist