Provider Demographics
NPI:1104355981
Name:SCOTT, BRIA NOELLE (DDS)
Entity Type:Individual
Prefix:DR
First Name:BRIA
Middle Name:NOELLE
Last Name:SCOTT
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2320 NORTHPARK DR STE B
Mailing Address - Street 2:
Mailing Address - City:COLUMBUS
Mailing Address - State:IN
Mailing Address - Zip Code:47203-4482
Mailing Address - Country:US
Mailing Address - Phone:812-603-4518
Mailing Address - Fax:
Practice Address - Street 1:2320 NORTHPARK DR STE B
Practice Address - Street 2:
Practice Address - City:COLUMBUS
Practice Address - State:IN
Practice Address - Zip Code:47203-4482
Practice Address - Country:US
Practice Address - Phone:812-603-4518
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-06-06
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN12012733A122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist