Provider Demographics
NPI:1528553195
Name:SCOTT, JULIE
Entity Type:Individual
Prefix:DR
First Name:JULIE
Middle Name:
Last Name:SCOTT
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2489 COBBS FORD RD
Mailing Address - Street 2:
Mailing Address - City:PRATTVILLE
Mailing Address - State:AL
Mailing Address - Zip Code:36066-7899
Mailing Address - Country:US
Mailing Address - Phone:334-290-8095
Mailing Address - Fax:334-517-6219
Practice Address - Street 1:2489 COBBS FORD RD
Practice Address - Street 2:
Practice Address - City:PRATTVILLE
Practice Address - State:AL
Practice Address - Zip Code:36066-7899
Practice Address - Country:US
Practice Address - Phone:334-290-8095
Practice Address - Fax:334-517-6219
Is Sole Proprietor?:No
Enumeration Date:2018-06-26
Last Update Date:2020-08-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL6688122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist