Provider Demographics
NPI:1659940575
Name:BECKER AND SCOTT DDS, LLC
Entity Type:Organization
Organization Name:BECKER AND SCOTT DDS, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/ORTHODONTIST
Authorized Official - Prefix:DR
Authorized Official - First Name:CRAIG
Authorized Official - Middle Name:STEPHEN
Authorized Official - Last Name:SCOTT
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:417-881-4300
Mailing Address - Street 1:3836 S FREMONT AVE
Mailing Address - Street 2:
Mailing Address - City:SPRINGFIELD
Mailing Address - State:MO
Mailing Address - Zip Code:65804-6503
Mailing Address - Country:US
Mailing Address - Phone:417-881-4300
Mailing Address - Fax:417-881-0776
Practice Address - Street 1:3836 S FREMONT AVE
Practice Address - Street 2:
Practice Address - City:SPRINGFIELD
Practice Address - State:MO
Practice Address - Zip Code:65804-6503
Practice Address - Country:US
Practice Address - Phone:417-881-4300
Practice Address - Fax:417-881-0776
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-06-24
Last Update Date:2021-06-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223X0400XDental ProvidersDentistOrthodontics and Dentofacial OrthopedicsGroup - Single Specialty