Provider Demographics
NPI:1326190257
Name:ARMITAGE, SCOTT ALAN (DDS)
Entity Type:Individual
Prefix:DR
First Name:SCOTT
Middle Name:ALAN
Last Name:ARMITAGE
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:PO BOX 338
Mailing Address - Street 2:
Mailing Address - City:CLOVERDALE
Mailing Address - State:IN
Mailing Address - Zip Code:46120-0338
Mailing Address - Country:US
Mailing Address - Phone:765-795-6263
Mailing Address - Fax:
Practice Address - Street 1:104 S MAIN ST
Practice Address - Street 2:
Practice Address - City:CLOVERDALE
Practice Address - State:IN
Practice Address - Zip Code:46120-8422
Practice Address - Country:US
Practice Address - Phone:765-795-6263
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-18
Last Update Date:2024-04-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN12008201A1223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice