Provider Demographics
NPI:1629567607
Name:SCOTT V. LAW, D.M.D. MISSOURI, LLC
Entity Type:Organization
Organization Name:SCOTT V. LAW, D.M.D. MISSOURI, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:SCOTT
Authorized Official - Middle Name:V
Authorized Official - Last Name:LAW
Authorized Official - Suffix:
Authorized Official - Credentials:DMD
Authorized Official - Phone:970-226-5505
Mailing Address - Street 1:4360 BOARDWALK DR STE 200
Mailing Address - Street 2:
Mailing Address - City:FORT COLLINS
Mailing Address - State:CO
Mailing Address - Zip Code:80525-5940
Mailing Address - Country:US
Mailing Address - Phone:970-226-5505
Mailing Address - Fax:
Practice Address - Street 1:315 NICHOLS RD STE 208
Practice Address - Street 2:
Practice Address - City:KANSAS CITY
Practice Address - State:MO
Practice Address - Zip Code:64112-1554
Practice Address - Country:US
Practice Address - Phone:816-753-0377
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-05-06
Last Update Date:2018-05-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO20170358871223X0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223X0400XDental ProvidersDentistOrthodontics and Dentofacial OrthopedicsGroup - Single Specialty