Provider Demographics
NPI:1851398762
Name:SCARR, ROBERT D (DDS)
Entity Type:Individual
Prefix:
First Name:ROBERT
Middle Name:D
Last Name:SCARR
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 1:899 N WILMOT RD
Mailing Address - Street 2:SUITE E-4
Mailing Address - City:TUCSON
Mailing Address - State:AZ
Mailing Address - Zip Code:85711-1714
Mailing Address - Country:US
Mailing Address - Phone:520-745-9723
Mailing Address - Fax:
Practice Address - Street 1:899 N WILMOT RD
Practice Address - Street 2:SUITE E-4
Practice Address - City:TUCSON
Practice Address - State:AZ
Practice Address - Zip Code:85711-1714
Practice Address - Country:US
Practice Address - Phone:520-745-9723
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2005-07-07
Last Update Date:2009-06-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZD6734122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NM51856816Medicaid