Provider Demographics
NPI:1437152089
Name:LEARN, SCOTT ELWYN (DMD)
Entity Type:Individual
Prefix:DR
First Name:SCOTT
Middle Name:ELWYN
Last Name:LEARN
Suffix:
Gender:M
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1000 SHARKY'S LANE
Mailing Address - Street 2:SUITE 102
Mailing Address - City:LATROBE
Mailing Address - State:PA
Mailing Address - Zip Code:15650
Mailing Address - Country:US
Mailing Address - Phone:724-537-3314
Mailing Address - Fax:724-537-3257
Practice Address - Street 1:1000 SHARKY'S LANE
Practice Address - Street 2:SUITE 102
Practice Address - City:LATROBE
Practice Address - State:PA
Practice Address - Zip Code:15650
Practice Address - Country:US
Practice Address - Phone:724-537-3314
Practice Address - Fax:724-537-3257
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-05-27
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PADS029241L1223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice