Provider Demographics
NPI:1467574269
Name:SCOTT R MUSIL DDS
Entity Type:Organization
Organization Name:SCOTT R MUSIL DDS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:SCOTT
Authorized Official - Middle Name:ROBERT
Authorized Official - Last Name:MUSIL
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:708-749-2040
Mailing Address - Street 1:3905 S OAK PARK AVE
Mailing Address - Street 2:
Mailing Address - City:STICKNEY
Mailing Address - State:IL
Mailing Address - Zip Code:60402-4169
Mailing Address - Country:US
Mailing Address - Phone:708-749-2040
Mailing Address - Fax:708-749-9843
Practice Address - Street 1:3905 S OAK PARK AVE
Practice Address - Street 2:
Practice Address - City:STICKNEY
Practice Address - State:IL
Practice Address - Zip Code:60402-4169
Practice Address - Country:US
Practice Address - Phone:708-749-2040
Practice Address - Fax:708-749-9843
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-04-04
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Multi-Specialty