Provider Demographics
NPI:1255443404
Name:NIGHTINGALE, SCOTT HAROLD (DDS MS)
Entity type:Individual
Prefix:DR
First Name:SCOTT
Middle Name:HAROLD
Last Name:NIGHTINGALE
Suffix:
Gender:M
Credentials:DDS MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5800 MONROE STREET
Mailing Address - Street 2:BLDG G
Mailing Address - City:SYLVANIA
Mailing Address - State:OH
Mailing Address - Zip Code:43560-2263
Mailing Address - Country:US
Mailing Address - Phone:419-882-3344
Mailing Address - Fax:419-824-9603
Practice Address - Street 1:5800 MONROE STREET
Practice Address - Street 2:BLDG G
Practice Address - City:SYLVANIA
Practice Address - State:OH
Practice Address - Zip Code:43560-2263
Practice Address - Country:US
Practice Address - Phone:419-882-3344
Practice Address - Fax:419-824-9603
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-31
Last Update Date:2011-05-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH153141223P0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223P0300XDental ProvidersDentistPeriodontics