Provider Demographics
NPI:1891825477
Name:SCOTT, PAUL H (DMD)
Entity Type:Individual
Prefix:
First Name:PAUL
Middle Name:H
Last Name:SCOTT
Suffix:
Gender:M
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10224 SHELBYVILLE RD
Mailing Address - Street 2:
Mailing Address - City:LOUISVILLE
Mailing Address - State:KY
Mailing Address - Zip Code:40223-2978
Mailing Address - Country:US
Mailing Address - Phone:502-245-1237
Mailing Address - Fax:502-245-2231
Practice Address - Street 1:10224 SHELBYVILLE RD
Practice Address - Street 2:
Practice Address - City:LOUISVILLE
Practice Address - State:KY
Practice Address - Zip Code:40223-2978
Practice Address - Country:US
Practice Address - Phone:502-245-1237
Practice Address - Fax:502-245-2231
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-06
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY44011223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice