Provider Demographics
NPI:1255411138
Name:SALANCY, SCOTT BAKER (DMD)
Entity type:Individual
Prefix:
First Name:SCOTT
Middle Name:BAKER
Last Name:SALANCY
Suffix:
Gender:M
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1015 COURT YARD PLZ
Mailing Address - Street 2:
Mailing Address - City:LATROBE
Mailing Address - State:PA
Mailing Address - Zip Code:15650-1838
Mailing Address - Country:US
Mailing Address - Phone:724-539-2528
Mailing Address - Fax:724-539-1359
Practice Address - Street 1:1015 COURT YARD PLZ
Practice Address - Street 2:
Practice Address - City:LATROBE
Practice Address - State:PA
Practice Address - Zip Code:15650-1838
Practice Address - Country:US
Practice Address - Phone:724-539-2528
Practice Address - Fax:724-539-1359
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-16
Last Update Date:2010-02-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PADS026353L1223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice