Provider Demographics
NPI:1821159963
Name:SCARBROUGH, FRANK E (DMD)
Entity Type:Individual
Prefix:DR
First Name:FRANK
Middle Name:E
Last Name:SCARBROUGH
Suffix:
Gender:M
Credentials:DMD
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:145 TRADERS WAY
Mailing Address - Street 2:SUITE A
Mailing Address - City:POOLER
Mailing Address - State:GA
Mailing Address - Zip Code:31322-6005
Mailing Address - Country:US
Mailing Address - Phone:912-748-4365
Mailing Address - Fax:912-748-0671
Practice Address - Street 1:4849 PAULSEN ST
Practice Address - Street 2:SUITE 312
Practice Address - City:SAVANNAH
Practice Address - State:GA
Practice Address - Zip Code:31405-4423
Practice Address - Country:US
Practice Address - Phone:912-354-1515
Practice Address - Fax:912-354-8181
Is Sole Proprietor?:No
Enumeration Date:2006-12-13
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA0111651223S0112X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223S0112XDental ProvidersDentistOral and Maxillofacial Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA00786376CMedicaid
GA19NCCCGMedicare ID - Type Unspecified
GA19NCCCGMedicare UPIN