Provider Demographics
NPI:1578049839
Name:SCOTT MCNAIRY DDS PLLC
Entity Type:Organization
Organization Name:SCOTT MCNAIRY DDS PLLC
Other - Org Name:NORTH PEAK DENTAL
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:SCOTT
Authorized Official - Middle Name:DENNIS
Authorized Official - Last Name:MCNAIRY
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:970-689-9759
Mailing Address - Street 1:1136 E STUART ST STE 3140
Mailing Address - Street 2:
Mailing Address - City:FORT COLLINS
Mailing Address - State:CO
Mailing Address - Zip Code:80525-1196
Mailing Address - Country:US
Mailing Address - Phone:970-482-1520
Mailing Address - Fax:970-482-1752
Practice Address - Street 1:1136 E STUART ST STE 3140
Practice Address - Street 2:
Practice Address - City:FORT COLLINS
Practice Address - State:CO
Practice Address - Zip Code:80525-1196
Practice Address - Country:US
Practice Address - Phone:970-482-1520
Practice Address - Fax:970-482-1752
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-07-19
Last Update Date:2018-07-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO002030571223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty