Provider Demographics
NPI:1972549418
Name:COLD, SCOTT PAUL (DDS)
Entity Type:Individual
Prefix:DR
First Name:SCOTT
Middle Name:PAUL
Last Name:COLD
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 1:4546 S ATHERTON DR STE 201
Mailing Address - Street 2:
Mailing Address - City:SALT LAKE CITY
Mailing Address - State:UT
Mailing Address - Zip Code:84123-6968
Mailing Address - Country:US
Mailing Address - Phone:801-965-9898
Mailing Address - Fax:801-965-6194
Practice Address - Street 1:4546 S ATHERTON DR STE 201
Practice Address - Street 2:
Practice Address - City:SALT LAKE CITY
Practice Address - State:UT
Practice Address - Zip Code:84123-6968
Practice Address - Country:US
Practice Address - Phone:801-965-9898
Practice Address - Fax:801-965-6194
Is Sole Proprietor?:Yes
Enumeration Date:2006-06-22
Last Update Date:2018-12-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT5329217-99221223G0001X, 332B00000X, 332BC3200X, 122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist
No1223G0001XDental ProvidersDentistGeneral Practice
No332B00000XSuppliersDurable Medical Equipment & Medical Supplies
No332BC3200XSuppliersDurable Medical Equipment & Medical SuppliesCustomized Equipment
Provider Identifiers
StateIdentifier IDID TypeIssuer
UT1666632OtherUNITED CONCORDIA ID
UT5329217990001OtherBLUECROSS ID NUMBER