Provider Demographics
NPI:1821002494
Name:GRIFFITH, SCOTT BANNER (DDS)
Entity Type:Individual
Prefix:DR
First Name:SCOTT
Middle Name:BANNER
Last Name:GRIFFITH
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 1:334 E MAIN ST
Mailing Address - Street 2:
Mailing Address - City:FOREST CITY
Mailing Address - State:NC
Mailing Address - Zip Code:28043-3103
Mailing Address - Country:US
Mailing Address - Phone:828-245-4194
Mailing Address - Fax:828-245-4825
Practice Address - Street 1:334 E MAIN ST
Practice Address - Street 2:
Practice Address - City:FOREST CITY
Practice Address - State:NC
Practice Address - Zip Code:28043-3103
Practice Address - Country:US
Practice Address - Phone:828-245-4194
Practice Address - Fax:828-245-4825
Is Sole Proprietor?:No
Enumeration Date:2006-07-28
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC5772122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist