Provider Demographics
NPI:1962816173
Name:DEAR, SCOTT XAVIER (DDS)
Entity Type:Individual
Prefix:DR
First Name:SCOTT
Middle Name:XAVIER
Last Name:DEAR
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 1:130 N MONROE ST
Mailing Address - Street 2:
Mailing Address - City:VERSAILLES
Mailing Address - State:MO
Mailing Address - Zip Code:65084-1288
Mailing Address - Country:US
Mailing Address - Phone:573-378-5488
Mailing Address - Fax:573-378-5488
Practice Address - Street 1:130 N MONROE ST
Practice Address - Street 2:
Practice Address - City:VERSAILLES
Practice Address - State:MO
Practice Address - Zip Code:65084-1288
Practice Address - Country:US
Practice Address - Phone:573-378-5488
Practice Address - Fax:573-378-5488
Is Sole Proprietor?:No
Enumeration Date:2014-06-16
Last Update Date:2014-06-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2014018079122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist