Provider Demographics
NPI:1578684858
Name:PAUL E. SCRUGGS, DDS PA
Entity Type:Organization
Organization Name:PAUL E. SCRUGGS, DDS PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:PAUL
Authorized Official - Middle Name:E
Authorized Official - Last Name:SCRUGGS
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:919-846-6622
Mailing Address - Street 1:7200 STONEHENGE DR
Mailing Address - Street 2:SUITE 210
Mailing Address - City:RALEIGH
Mailing Address - State:NC
Mailing Address - Zip Code:27613-1620
Mailing Address - Country:US
Mailing Address - Phone:919-846-6622
Mailing Address - Fax:919-846-8012
Practice Address - Street 1:7200 STONEHENGE DR
Practice Address - Street 2:SUITE 210
Practice Address - City:RALEIGH
Practice Address - State:NC
Practice Address - Zip Code:27613-1620
Practice Address - Country:US
Practice Address - Phone:919-846-6622
Practice Address - Fax:919-846-8012
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-04-03
Last Update Date:2007-10-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC50541223P0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223P0700XDental ProvidersDentistProsthodonticsGroup - Single Specialty