Provider Demographics
NPI:1861044596
Name:ALEX W SCOTT DMD PLLC
Entity Type:Organization
Organization Name:ALEX W SCOTT DMD PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DENTIST
Authorized Official - Prefix:DR
Authorized Official - First Name:ALEX
Authorized Official - Middle Name:WILLIAM
Authorized Official - Last Name:SCOTT
Authorized Official - Suffix:
Authorized Official - Credentials:DMD
Authorized Official - Phone:602-265-5155
Mailing Address - Street 1:5155 N 16TH ST STE A
Mailing Address - Street 2:
Mailing Address - City:PHOENIX
Mailing Address - State:AZ
Mailing Address - Zip Code:85016-3917
Mailing Address - Country:US
Mailing Address - Phone:602-265-5155
Mailing Address - Fax:
Practice Address - Street 1:5155 N 16TH ST STE A
Practice Address - Street 2:
Practice Address - City:PHOENIX
Practice Address - State:AZ
Practice Address - Zip Code:85016-3917
Practice Address - Country:US
Practice Address - Phone:602-265-5155
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-07-12
Last Update Date:2019-07-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QD0000XAmbulatory Health Care FacilitiesClinic/CenterDental