Provider Demographics
NPI:1417967852
Name:HARPER, SCOTT R (DDS, MS)
Entity Type:Individual
Prefix:DR
First Name:SCOTT
Middle Name:R
Last Name:HARPER
Suffix:
Gender:M
Credentials:DDS, MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Mailing Address - Street 1:101 CIVIC CENTER PLZ
Mailing Address - Street 2:SUITE A
Mailing Address - City:LOMPOC
Mailing Address - State:CA
Mailing Address - Zip Code:93436-6944
Mailing Address - Country:US
Mailing Address - Phone:805-736-3486
Mailing Address - Fax:805-736-3248
Practice Address - Street 1:101 CIVIC CENTER PLZ
Practice Address - Street 2:SUITE A
Practice Address - City:LOMPOC
Practice Address - State:CA
Practice Address - Zip Code:93436-6944
Practice Address - Country:US
Practice Address - Phone:805-736-3486
Practice Address - Fax:805-736-3248
Is Sole Proprietor?:No
Enumeration Date:2006-08-08
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA500631223X0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223X0400XDental ProvidersDentistOrthodontics and Dentofacial Orthopedics