Provider Demographics
NPI:1184748717
Name:WELLMAN, SCOTT V (DDS)
Entity type:Individual
Prefix:DR
First Name:SCOTT
Middle Name:V
Last Name:WELLMAN
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 1:305 TISBURY CT
Mailing Address - Street 2:
Mailing Address - City:LEXINGTON
Mailing Address - State:SC
Mailing Address - Zip Code:29072-7748
Mailing Address - Country:US
Mailing Address - Phone:623-910-0407
Mailing Address - Fax:
Practice Address - Street 1:101 R L SAWYER MD DR
Practice Address - Street 2:
Practice Address - City:SALUDA
Practice Address - State:SC
Practice Address - Zip Code:29138-9199
Practice Address - Country:US
Practice Address - Phone:864-445-8168
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-03-19
Last Update Date:2013-12-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC8210122300000X
AZD69481223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist
No1223G0001XDental ProvidersDentistGeneral Practice