Provider Demographics
NPI:1568667988
Name:SCOTT A MCCLAIN DDS PC
Entity Type:Organization
Organization Name:SCOTT A MCCLAIN DDS PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:SCOTT
Authorized Official - Middle Name:ALAN
Authorized Official - Last Name:MCCLAIN
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:312-921-1222
Mailing Address - Street 1:2758 N US HIGHWAY 67
Mailing Address - Street 2:
Mailing Address - City:FLORISSANT
Mailing Address - State:MO
Mailing Address - Zip Code:63033-1402
Mailing Address - Country:US
Mailing Address - Phone:314-921-1222
Mailing Address - Fax:314-921-4472
Practice Address - Street 1:2758 N US HIGHWAY 67
Practice Address - Street 2:
Practice Address - City:FLORISSANT
Practice Address - State:MO
Practice Address - Zip Code:63033-1402
Practice Address - Country:US
Practice Address - Phone:314-921-1222
Practice Address - Fax:314-921-4472
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-06-16
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO0153091223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty