Provider Demographics
NPI:1356077648
Name:SCOTT A. DEXTER, DDS, PC
Entity Type:Organization
Organization Name:SCOTT A. DEXTER, DDS, PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:SCOTT
Authorized Official - Middle Name:ALAN
Authorized Official - Last Name:DEXTER
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:517-321-8280
Mailing Address - Street 1:815 KIDS CT
Mailing Address - Street 2:
Mailing Address - City:LANSING
Mailing Address - State:MI
Mailing Address - Zip Code:48917-4082
Mailing Address - Country:US
Mailing Address - Phone:517-321-8280
Mailing Address - Fax:517-321-3339
Practice Address - Street 1:815 KIDS CT
Practice Address - Street 2:
Practice Address - City:LANSING
Practice Address - State:MI
Practice Address - Zip Code:48917-4082
Practice Address - Country:US
Practice Address - Phone:517-321-8280
Practice Address - Fax:517-321-3339
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-07-28
Last Update Date:2022-07-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223P0221XDental ProvidersDentistPediatric DentistryGroup - Single Specialty