Provider Demographics
NPI:1497839443
Name:SCOTT, BRYAN M (DDS)
Entity Type:Individual
Prefix:
First Name:BRYAN
Middle Name:M
Last Name:SCOTT
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1790 TOWN PARK BLVD
Mailing Address - Street 2:
Mailing Address - City:UNIONTOWN
Mailing Address - State:OH
Mailing Address - Zip Code:44685-7972
Mailing Address - Country:US
Mailing Address - Phone:330-899-9001
Mailing Address - Fax:330-899-9000
Practice Address - Street 1:1790 TOWN PARK BLVD
Practice Address - Street 2:
Practice Address - City:UNIONTOWN
Practice Address - State:OH
Practice Address - Zip Code:44685-7972
Practice Address - Country:US
Practice Address - Phone:330-899-9001
Practice Address - Fax:330-899-9000
Is Sole Proprietor?:No
Enumeration Date:2006-10-25
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH30.0209841223S0112X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223S0112XDental ProvidersDentistOral and Maxillofacial Surgery