Provider Demographics
NPI:1093843526
Name:BROWN, SCOTT T (DDS)
Entity type:Individual
Prefix:DR
First Name:SCOTT
Middle Name:T
Last Name:BROWN
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 1:329 N WEST ST
Mailing Address - Street 2:
Mailing Address - City:LIMA
Mailing Address - State:OH
Mailing Address - Zip Code:45801-4332
Mailing Address - Country:US
Mailing Address - Phone:419-221-3072
Mailing Address - Fax:
Practice Address - Street 1:441 E 8TH ST
Practice Address - Street 2:
Practice Address - City:LIMA
Practice Address - State:OH
Practice Address - Zip Code:45804-2482
Practice Address - Country:US
Practice Address - Phone:419-221-3072
Practice Address - Fax:419-225-8878
Is Sole Proprietor?:No
Enumeration Date:2007-02-28
Last Update Date:2024-01-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH30-0219841223G0001X, 1223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice