Provider Demographics
NPI:1265566947
Name:DOWLEARN, SCOTT WALTON (DDS)
Entity type:Individual
Prefix:DR
First Name:SCOTT
Middle Name:WALTON
Last Name:DOWLEARN
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:PO BOX 789
Mailing Address - Street 2:
Mailing Address - City:ATHENS
Mailing Address - State:TX
Mailing Address - Zip Code:75751-0789
Mailing Address - Country:US
Mailing Address - Phone:903-675-4124
Mailing Address - Fax:903-677-2852
Practice Address - Street 1:710 LUCAS DR
Practice Address - Street 2:
Practice Address - City:ATHENS
Practice Address - State:TX
Practice Address - Zip Code:75751-3434
Practice Address - Country:US
Practice Address - Phone:903-675-4124
Practice Address - Fax:903-677-2852
Is Sole Proprietor?:No
Enumeration Date:2007-03-15
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX222341223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice