Provider Demographics
NPI:1891915559
Name:SCOTT, HADEN CREWS (DDS)
Entity Type:Individual
Prefix:DR
First Name:HADEN
Middle Name:CREWS
Last Name:SCOTT
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 1:208 SOUTH IRISH ST
Mailing Address - Street 2:
Mailing Address - City:GREENVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37743-4918
Mailing Address - Country:US
Mailing Address - Phone:423-639-5621
Mailing Address - Fax:
Practice Address - Street 1:208 SOUTH IRISH ST
Practice Address - Street 2:
Practice Address - City:GREENVILLE
Practice Address - State:TN
Practice Address - Zip Code:37743-4918
Practice Address - Country:US
Practice Address - Phone:423-639-5621
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-04-26
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TNDS0000003353122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist