Provider Demographics
NPI:1548383193
Name:SCOTT, GEORGE CRAWFORD III (DDS)
Entity Type:Individual
Prefix:DR
First Name:GEORGE
Middle Name:CRAWFORD
Last Name:SCOTT
Suffix:III
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 1:5305 BEECHWOOD POINT CT
Mailing Address - Street 2:
Mailing Address - City:MIDLOTHIAN
Mailing Address - State:VA
Mailing Address - Zip Code:23112-2535
Mailing Address - Country:US
Mailing Address - Phone:804-739-1421
Mailing Address - Fax:
Practice Address - Street 1:4901 EAST PATRICK HENRY HIGHWAY
Practice Address - Street 2:
Practice Address - City:BURKEVILLE
Practice Address - State:VA
Practice Address - Zip Code:23922
Practice Address - Country:US
Practice Address - Phone:434-767-7885
Practice Address - Fax:434-767-5205
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-09
Last Update Date:2013-07-25
Deactivation Date:2007-07-17
Deactivation Code:
Reactivation Date:2013-07-25
Provider Licenses
StateLicense IDTaxonomies
VA0401006948122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist