Provider Demographics
NPI:1598787707
Name:ARMSTRONG, SCOTT A (DDS)
Entity Type:Individual
Prefix:DR
First Name:SCOTT
Middle Name:A
Last Name:ARMSTRONG
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:4001 STINSON BLVD STE 420
Mailing Address - Street 2:
Mailing Address - City:MINNEAPOLIS
Mailing Address - State:MN
Mailing Address - Zip Code:55421-3424
Mailing Address - Country:US
Mailing Address - Phone:612-788-5151
Mailing Address - Fax:612-788-9698
Practice Address - Street 1:4001 STINSON BLVD
Practice Address - Street 2:SUITE 420
Practice Address - City:MINNEAPOLIS
Practice Address - State:MN
Practice Address - Zip Code:55421-3488
Practice Address - Country:US
Practice Address - Phone:612-788-5151
Practice Address - Fax:612-788-9698
Is Sole Proprietor?:No
Enumeration Date:2006-07-24
Last Update Date:2020-08-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN100061223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice
Provider Identifiers
StateIdentifier IDID TypeIssuer
MN1598787707Medicaid
MN647820400Medicaid