Provider Demographics
NPI:1942415963
Name:G.SCOTTPRATTDDS.,INC.
Entity Type:Organization
Organization Name:G.SCOTTPRATTDDS.,INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:G.
Authorized Official - Middle Name:SCOTT
Authorized Official - Last Name:PRATT
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:440-322-1725
Mailing Address - Street 1:301 EAST AVE
Mailing Address - Street 2:
Mailing Address - City:ELYRIA
Mailing Address - State:OH
Mailing Address - Zip Code:44035-5736
Mailing Address - Country:US
Mailing Address - Phone:440-322-1725
Mailing Address - Fax:
Practice Address - Street 1:301 EAST AVE
Practice Address - Street 2:
Practice Address - City:ELYRIA
Practice Address - State:OH
Practice Address - Zip Code:44035-5736
Practice Address - Country:US
Practice Address - Phone:440-322-1725
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-12
Last Update Date:2008-05-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH178201223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty