Provider Demographics
NPI:1912188061
Name:BENTSON, SCOTT D (DC, MS)
Entity Type:Individual
Prefix:DR
First Name:SCOTT
Middle Name:D
Last Name:BENTSON
Suffix:
Gender:M
Credentials:DC, MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5325 NORTHGATE DR STE 206
Mailing Address - Street 2:
Mailing Address - City:BETHLEHEM
Mailing Address - State:PA
Mailing Address - Zip Code:18017-9416
Mailing Address - Country:US
Mailing Address - Phone:610-868-6800
Mailing Address - Fax:610-868-6806
Practice Address - Street 1:5325 NORTHGATE DR STE 206
Practice Address - Street 2:
Practice Address - City:BETHLEHEM
Practice Address - State:PA
Practice Address - Zip Code:18017-9416
Practice Address - Country:US
Practice Address - Phone:610-868-6800
Practice Address - Fax:610-868-6806
Is Sole Proprietor?:No
Enumeration Date:2007-11-16
Last Update Date:2022-07-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PADC009853111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA119779Medicare PIN