Provider Demographics
NPI:1962505446
Name:MUSCOTT, JAMES ROGER (DMD)
Entity Type:Individual
Prefix:DR
First Name:JAMES
Middle Name:ROGER
Last Name:MUSCOTT
Suffix:
Gender:M
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:89 OLD TROLLEY ROAD
Mailing Address - Street 2:SUITE A
Mailing Address - City:SUMMERVILLE
Mailing Address - State:SC
Mailing Address - Zip Code:29485
Mailing Address - Country:US
Mailing Address - Phone:843-873-1261
Mailing Address - Fax:843-871-3701
Practice Address - Street 1:89 OLD TROLLEY ROAD
Practice Address - Street 2:SUITE A
Practice Address - City:SUMMERVILLE
Practice Address - State:SC
Practice Address - Zip Code:29485
Practice Address - Country:US
Practice Address - Phone:843-873-1261
Practice Address - Fax:843-871-3701
Is Sole Proprietor?:No
Enumeration Date:2006-09-07
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC1859122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist