Provider Demographics
NPI:1376645440
Name:RENFROW, SCOTT (DDS,MS)
Entity Type:Individual
Prefix:DR
First Name:SCOTT
Middle Name:
Last Name:RENFROW
Suffix:
Gender:M
Credentials:DDS,MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:521 MERCHANT DR
Mailing Address - Street 2:
Mailing Address - City:NORMAN
Mailing Address - State:OK
Mailing Address - Zip Code:73069-6575
Mailing Address - Country:US
Mailing Address - Phone:405-329-6106
Mailing Address - Fax:405-329-6107
Practice Address - Street 1:521 MERCHANT DR
Practice Address - Street 2:
Practice Address - City:NORMAN
Practice Address - State:OK
Practice Address - Zip Code:73069
Practice Address - Country:US
Practice Address - Phone:405-329-6106
Practice Address - Fax:405-329-6107
Is Sole Proprietor?:No
Enumeration Date:2006-09-01
Last Update Date:2018-08-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK58141223G0001X
OK581223P0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223P0300XDental ProvidersDentistPeriodontics
No1223G0001XDental ProvidersDentistGeneral Practice