Provider Demographics
NPI:1326698713
Name:GINGER SCOGGINS D.D.S. I.N.C.
Entity Type:Organization
Organization Name:GINGER SCOGGINS D.D.S. I.N.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:MRS
Authorized Official - First Name:NICOLE
Authorized Official - Middle Name:MARIE
Authorized Official - Last Name:COBO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:760-244-3112
Mailing Address - Street 1:13605 BEAR VALLEY RD STE 105A
Mailing Address - Street 2:
Mailing Address - City:VICTORVILLE
Mailing Address - State:CA
Mailing Address - Zip Code:92392-6660
Mailing Address - Country:US
Mailing Address - Phone:760-244-3112
Mailing Address - Fax:760-244-7191
Practice Address - Street 1:13605 BEAR VALLEY RD STE 105A
Practice Address - Street 2:
Practice Address - City:VICTORVILLE
Practice Address - State:CA
Practice Address - Zip Code:92392-6660
Practice Address - Country:US
Practice Address - Phone:760-244-3112
Practice Address - Fax:760-244-7191
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-09-17
Last Update Date:2019-09-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty