Provider Demographics
NPI:1558472332
Name:RICHARD F SCOTT DDS MS PC
Entity Type:Organization
Organization Name:RICHARD F SCOTT DDS MS PC
Other - Org Name:ORAL & MAXILLOFACIAL SURGERY OF ANN ARBOR
Other - Org Type:Other Name
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:NICHOLE
Authorized Official - Middle Name:
Authorized Official - Last Name:LAYNE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:734-994-1040
Mailing Address - Street 1:203 S ZEEB ROAD
Mailing Address - Street 2:SUITE 101
Mailing Address - City:ANN ARBOR
Mailing Address - State:MI
Mailing Address - Zip Code:48103
Mailing Address - Country:US
Mailing Address - Phone:734-994-1040
Mailing Address - Fax:734-994-3022
Practice Address - Street 1:203 S ZEEB ROAD
Practice Address - Street 2:SUITE 101
Practice Address - City:ANN ARBOR
Practice Address - State:MI
Practice Address - Zip Code:48103
Practice Address - Country:US
Practice Address - Phone:734-994-1040
Practice Address - Fax:734-994-3022
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-31
Last Update Date:2011-12-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes204E00000XAllopathic & Osteopathic PhysiciansOral & Maxillofacial SurgeryGroup - Multi-Specialty