Provider Demographics
NPI:1740309327
Name:SCOTT, BRETT C (DDS)
Entity type:Individual
Prefix:DR
First Name:BRETT
Middle Name:C
Last Name:SCOTT
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:199 FAIRTHORNE DR
Mailing Address - Street 2:
Mailing Address - City:LEESBURG
Mailing Address - State:GA
Mailing Address - Zip Code:31763-5393
Mailing Address - Country:US
Mailing Address - Phone:229-594-5233
Mailing Address - Fax:
Practice Address - Street 1:1030 W GORDON AVE
Practice Address - Street 2:SUITE A
Practice Address - City:ALBANY
Practice Address - State:GA
Practice Address - Zip Code:31701-4514
Practice Address - Country:US
Practice Address - Phone:229-432-9555
Practice Address - Fax:229-432-0907
Is Sole Proprietor?:No
Enumeration Date:2007-03-28
Last Update Date:2011-09-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GADN0131941223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice