Provider Demographics
NPI:1790812923
Name:ROSS, SCOTT BENNETT (DDS, PA)
Entity Type:Individual
Prefix:DR
First Name:SCOTT
Middle Name:BENNETT
Last Name:ROSS
Suffix:
Gender:M
Credentials:DDS, PA
Other - Prefix:
Other - First Name:
Other - Middle Name:
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Other - Credentials:
Mailing Address - Street 1:8720 N KENDALL DR
Mailing Address - Street 2:103
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33176-2299
Mailing Address - Country:US
Mailing Address - Phone:305-270-1350
Mailing Address - Fax:305-274-9876
Practice Address - Street 1:8720 N KENDALL DR
Practice Address - Street 2:103
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33176-2299
Practice Address - Country:US
Practice Address - Phone:305-270-1350
Practice Address - Fax:305-274-9876
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-27
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
FL69821223P0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223P0300XDental ProvidersDentistPeriodontics