Provider Demographics
NPI:1891881199
Name:SCRUGGS, OSCAR DEWITT IV (DDS)
Entity Type:Individual
Prefix:DR
First Name:OSCAR
Middle Name:DEWITT
Last Name:SCRUGGS
Suffix:IV
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 1:76 CATES STREET
Mailing Address - Street 2:
Mailing Address - City:DUNLAP
Mailing Address - State:TN
Mailing Address - Zip Code:37327-3452
Mailing Address - Country:US
Mailing Address - Phone:423-949-2978
Mailing Address - Fax:423-949-3550
Practice Address - Street 1:76 CATES ST
Practice Address - Street 2:
Practice Address - City:DUNLAP
Practice Address - State:TN
Practice Address - Zip Code:37327-3452
Practice Address - Country:US
Practice Address - Phone:423-949-2978
Practice Address - Fax:423-949-3550
Is Sole Proprietor?:No
Enumeration Date:2006-10-05
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TNDS005138122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist